Provider First Line Business Practice Location Address:
500 THOMAS LN
Provider Second Line Business Practice Location Address:
COMMUNITY MEDICINE
Provider Business Practice Location Address City Name:
COLUMBUS
Provider Business Practice Location Address State Name:
OH
Provider Business Practice Location Address Postal Code:
43214-1419
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
614-566-4804
Provider Business Practice Location Address Fax Number:
614-566-2034
Provider Enumeration Date:
06/29/2006