Provider First Line Business Practice Location Address:
202 N.CHERRY ST.
Provider Second Line Business Practice Location Address:
WESTERN BUCKEYE ESC
Provider Business Practice Location Address City Name:
PAULDING
Provider Business Practice Location Address State Name:
OH
Provider Business Practice Location Address Postal Code:
45879
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
419-399-4711
Provider Business Practice Location Address Fax Number:
419-399-3346
Provider Enumeration Date:
08/06/2015