Provider First Line Business Practice Location Address:
1240 BOARDMAN CANFIELD RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
YOUNGSTOWN
Provider Business Practice Location Address State Name:
OH
Provider Business Practice Location Address Postal Code:
44512-4044
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
330-726-1689
Provider Business Practice Location Address Fax Number:
330-726-7107
Provider Enumeration Date:
10/27/2005