Provider First Line Business Practice Location Address:
THE OHIO STATE UNIVERSITY WEXNER MEDICAL CENTER
Provider Second Line Business Practice Location Address:
395 12TH AVENUE, THIRD FLOOR
Provider Business Practice Location Address City Name:
COLUMBUS
Provider Business Practice Location Address State Name:
OH
Provider Business Practice Location Address Postal Code:
43210
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
410-409-5744
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
05/04/2022