Provider First Line Business Practice Location Address:
7318 OHIO RIVER RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
PORTSMOUTH
Provider Business Practice Location Address State Name:
OH
Provider Business Practice Location Address Postal Code:
45662-5665
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
740-574-9549
Provider Business Practice Location Address Fax Number:
740-574-9064
Provider Enumeration Date:
03/31/2006