Provider First Line Business Practice Location Address:
3130 GLENDALE AVE
Provider Second Line Business Practice Location Address:
KOBACKER CENTER
Provider Business Practice Location Address City Name:
TOLEDO
Provider Business Practice Location Address State Name:
OH
Provider Business Practice Location Address Postal Code:
43614-5811
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
419-383-3815
Provider Business Practice Location Address Fax Number:
419-383-3098
Provider Enumeration Date:
05/09/2006