Provider First Line Business Practice Location Address:
415 S RIVER ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
NEWCOMERSTOWN
Provider Business Practice Location Address State Name:
OH
Provider Business Practice Location Address Postal Code:
43832-1443
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
740-492-0191
Provider Business Practice Location Address Fax Number:
740-492-0275
Provider Enumeration Date:
06/19/2013