Provider First Line Business Practice Location Address:
450 WEST TENTH AVENUE
Provider Second Line Business Practice Location Address:
DEPARTMENT OF NUTRITION S-07 RHODES HALL
Provider Business Practice Location Address City Name:
COLUMBUS
Provider Business Practice Location Address State Name:
OH
Provider Business Practice Location Address Postal Code:
43210
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
614-293-2300
Provider Business Practice Location Address Fax Number:
614-293-3740
Provider Enumeration Date:
04/12/2006