Provider First Line Business Practice Location Address:
1001 S. DEFIANCE ST.
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
ARCHBOLD
Provider Business Practice Location Address State Name:
OH
Provider Business Practice Location Address Postal Code:
43502-0038
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
419-445-5436
Provider Business Practice Location Address Fax Number:
419-446-4818
Provider Enumeration Date:
10/06/2008