Provider First Line Business Practice Location Address:
805 E HIGH AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
NEW PHILADELPHIA
Provider Business Practice Location Address State Name:
OH
Provider Business Practice Location Address Postal Code:
44663-3017
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
330-343-5815
Provider Business Practice Location Address Fax Number:
330-343-5020
Provider Enumeration Date:
08/15/2005