Provider First Line Business Practice Location Address:
8715 BIG BEAR AVENUE
Provider Second Line Business Practice Location Address:
SCIOTO RIDGE ELEMENTARY SCHOOL
Provider Business Practice Location Address City Name:
POWELL
Provider Business Practice Location Address State Name:
OH
Provider Business Practice Location Address Postal Code:
43065
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
740-657-4800
Provider Business Practice Location Address Fax Number:
740-657-4849
Provider Enumeration Date:
06/03/2014