Provider First Line Business Practice Location Address:
THE OHIO STATE UNIVERSITY WEXNER MEDICAL CENTER
Provider Second Line Business Practice Location Address:
395 W 12TH AVENUE, THIRD FLOOR
Provider Business Practice Location Address City Name:
COLUMBUS
Provider Business Practice Location Address State Name:
OH
Provider Business Practice Location Address Postal Code:
43210
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
614-293-3989
Provider Business Practice Location Address Fax Number:
614-293-9789
Provider Enumeration Date:
04/02/2019