Provider First Line Business Practice Location Address:
712 CHINA STREET
Provider Second Line Business Practice Location Address:
CROOKSVILLE FAMILY CLINIC INC.
Provider Business Practice Location Address City Name:
CROOKSVILLE
Provider Business Practice Location Address State Name:
OH
Provider Business Practice Location Address Postal Code:
43731-1124
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
740-982-6872
Provider Business Practice Location Address Fax Number:
740-982-5551
Provider Enumeration Date:
12/06/2006