Provider First Line Business Practice Location Address:
5420 MILAN RD
Provider Second Line Business Practice Location Address:
2500 W STRUB RD, SUITE 120 (ADDITIONAL LOCATION)
Provider Business Practice Location Address City Name:
SANDUSKY
Provider Business Practice Location Address State Name:
OH
Provider Business Practice Location Address Postal Code:
44870-5846
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
419-557-5248
Provider Business Practice Location Address Fax Number:
419-624-0566
Provider Enumeration Date:
01/08/2008