Provider First Line Business Practice Location Address:
4 COMMERCIAL AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
WASHINGTON COURT HOUSE
Provider Business Practice Location Address State Name:
OH
Provider Business Practice Location Address Postal Code:
43160-2197
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
740-333-7507
Provider Business Practice Location Address Fax Number:
740-335-3124
Provider Enumeration Date:
10/24/2006