Provider First Line Business Practice Location Address:
2155 ALLENTOWN RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
LIMA
Provider Business Practice Location Address State Name:
OH
Provider Business Practice Location Address Postal Code:
45805-1705
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
419-228-3800
Provider Business Practice Location Address Fax Number:
419-228-3134
Provider Enumeration Date:
01/29/2007