Provider First Line Business Practice Location Address:
770 WEST HIGH ST
Provider Second Line Business Practice Location Address:
SUITE 480
Provider Business Practice Location Address City Name:
LIMA
Provider Business Practice Location Address State Name:
OH
Provider Business Practice Location Address Postal Code:
45801
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
419-227-9500
Provider Business Practice Location Address Fax Number:
419-227-9503
Provider Enumeration Date:
04/30/2007