Provider First Line Business Practice Location Address:
111 S GRANT AVE
Provider Second Line Business Practice Location Address:
3RD FLOOR RADIOLOGY DEPT
Provider Business Practice Location Address City Name:
COLUMBUS
Provider Business Practice Location Address State Name:
OH
Provider Business Practice Location Address Postal Code:
43215-4701
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
614-566-9231
Provider Business Practice Location Address Fax Number:
614-566-8385
Provider Enumeration Date:
02/24/2006