Provider First Line Business Practice Location Address:
4 COMMERCIAL AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
WASHINGTON COURT HOUSE
Provider Business Practice Location Address State Name:
OH
Provider Business Practice Location Address Postal Code:
43160-2197
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
740-333-7296
Provider Business Practice Location Address Fax Number:
740-333-7866
Provider Enumeration Date:
03/17/2006