Provider First Line Business Practice Location Address:
312 E MARKET ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
WASHINGTON COURT HOUSE
Provider Business Practice Location Address State Name:
OH
Provider Business Practice Location Address Postal Code:
43160-1481
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
740-620-4069
Provider Business Practice Location Address Fax Number:
740-620-4072
Provider Enumeration Date:
05/07/2014