Provider First Line Business Practice Location Address:
509 S. 3RD AVENUE
Provider Second Line Business Practice Location Address:
M.C. SHAH MD INC
Provider Business Practice Location Address City Name:
MIDDLEPORT
Provider Business Practice Location Address State Name:
OH
Provider Business Practice Location Address Postal Code:
45760
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
740-444-5911
Provider Business Practice Location Address Fax Number:
740-444-5913
Provider Enumeration Date:
11/17/2006