Provider First Line Business Practice Location Address:
1490 S WATER ST
Provider Second Line Business Practice Location Address:
UNIVERSITY PLAZA
Provider Business Practice Location Address City Name:
KENT
Provider Business Practice Location Address State Name:
OH
Provider Business Practice Location Address Postal Code:
44240-3848
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
330-673-9129
Provider Business Practice Location Address Fax Number:
330-673-9305
Provider Enumeration Date:
08/19/2005