Provider First Line Business Practice Location Address:
240 PARSONS AVENUE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
COLUMBUS
Provider Business Practice Location Address State Name:
OH
Provider Business Practice Location Address Postal Code:
43215
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
614-645-6426
Provider Business Practice Location Address Fax Number:
614-645-1753
Provider Enumeration Date:
10/02/2006