Provider First Line Business Practice Location Address:
239 E COURT ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
WASHINGTON CH
Provider Business Practice Location Address State Name:
OH
Provider Business Practice Location Address Postal Code:
43160-1357
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
740-335-2771
Provider Business Practice Location Address Fax Number:
743-335-2771
Provider Enumeration Date:
08/04/2006