Provider First Line Business Practice Location Address:
1251 LINCOLN AVENUE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
WAPAKONETA
Provider Business Practice Location Address State Name:
OH
Provider Business Practice Location Address Postal Code:
45895
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
419-228-1000
Provider Business Practice Location Address Fax Number:
419-227-3085
Provider Enumeration Date:
04/01/2008