Provider First Line Business Practice Location Address:
5375 TILE PLANT RD SE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
NEW LEXINGTON
Provider Business Practice Location Address State Name:
OH
Provider Business Practice Location Address Postal Code:
43764-9801
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
740-342-3343
Provider Business Practice Location Address Fax Number:
740-342-4805
Provider Enumeration Date:
07/17/2026