Provider First Line Business Practice Location Address:
602 PARMALEE AVE
Provider Second Line Business Practice Location Address:
SUITE 100
Provider Business Practice Location Address City Name:
YOUNGSTOWN
Provider Business Practice Location Address State Name:
OH
Provider Business Practice Location Address Postal Code:
44510-1653
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
330-746-2657
Provider Business Practice Location Address Fax Number:
330-746-0014
Provider Enumeration Date:
10/19/2005