Provider First Line Business Practice Location Address:
125 E MAIN ST.
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
LOUISVILLE
Provider Business Practice Location Address State Name:
OH
Provider Business Practice Location Address Postal Code:
44641
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
330-753-3007
Provider Business Practice Location Address Fax Number:
330-753-3000
Provider Enumeration Date:
11/27/2006