Provider First Line Business Practice Location Address:
2000 REGENCY MANOR CIR
Provider Second Line Business Practice Location Address:
REHAB DEPT
Provider Business Practice Location Address City Name:
COLUMBUS
Provider Business Practice Location Address State Name:
OH
Provider Business Practice Location Address Postal Code:
43207-1777
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
419-601-1661
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
01/11/2012