Provider First Line Business Practice Location Address:
1337 N CABLE RD
Provider Second Line Business Practice Location Address:
STE B
Provider Business Practice Location Address City Name:
LIMA
Provider Business Practice Location Address State Name:
OH
Provider Business Practice Location Address Postal Code:
45805
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
419-228-8929
Provider Business Practice Location Address Fax Number:
419-228-0388
Provider Enumeration Date:
09/06/2006