Provider First Line Business Practice Location Address:
940 SECOND ST.
Provider Second Line Business Practice Location Address:
HEALTH SCIENCES DEPT.
Provider Business Practice Location Address City Name:
PORTSMOUTH
Provider Business Practice Location Address State Name:
OH
Provider Business Practice Location Address Postal Code:
45662-4344
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
740-351-3216
Provider Business Practice Location Address Fax Number:
740-351-3354
Provider Enumeration Date:
11/18/2008