Provider First Line Business Practice Location Address:
201 N DEFIANCE ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
ARCHBOLD
Provider Business Practice Location Address State Name:
OH
Provider Business Practice Location Address Postal Code:
43502-1160
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
419-445-4496
Provider Business Practice Location Address Fax Number:
419-445-8231
Provider Enumeration Date:
02/07/2007