Provider First Line Business Practice Location Address: 
6797 N HIGH ST STE 350
    Provider Second Line Business Practice Location Address: 
    Provider Business Practice Location Address City Name: 
WORTHINGTON
    Provider Business Practice Location Address State Name: 
OH
    Provider Business Practice Location Address Postal Code: 
43085-2533
    Provider Business Practice Location Address Country Code: 
US
    Provider Business Practice Location Address Telephone Number: 
614-888-9200
    Provider Business Practice Location Address Fax Number: 
614-888-3239
    Provider Enumeration Date: 
07/28/2011