Provider First Line Business Practice Location Address:
1072 N MAIN ST
Provider Second Line Business Practice Location Address:
BOWLING GREEN PAIN CLINIC
Provider Business Practice Location Address City Name:
BOWLING GREEN
Provider Business Practice Location Address State Name:
OH
Provider Business Practice Location Address Postal Code:
43402
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
419-354-6166
Provider Business Practice Location Address Fax Number:
419-354-6756
Provider Enumeration Date:
05/15/2006