Provider First Line Business Practice Location Address:
445 N HIGH ST
Provider Second Line Business Practice Location Address:
445 1/2 IS SIDE OFFICE
Provider Business Practice Location Address City Name:
CHILLICOTHEE
Provider Business Practice Location Address State Name:
OH
Provider Business Practice Location Address Postal Code:
45601
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
740-327-0400
Provider Business Practice Location Address Fax Number:
740-327-0500
Provider Enumeration Date:
02/15/2010