Provider First Line Business Practice Location Address:
238 S MERIDIAN RD STE B
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:
44509-2925
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
330-754-3217
Provider Business Practice Location Address Fax Number:
330-752-9284
Provider Enumeration Date:
10/03/2005