Provider First Line Business Practice Location Address:
830 W SOUTH BOUNDARY ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
PERRYSBURG
Provider Business Practice Location Address State Name:
OH
Provider Business Practice Location Address Postal Code:
43551
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
419-931-3020
Provider Business Practice Location Address Fax Number:
419-931-3022
Provider Enumeration Date:
01/06/2012