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| Type | Address | [sources] | |||
|---|---|---|---|---|---|
| Country | United States of America | [sources] | |||
| City | Lake Milton | [sources] | |||
| Full address | 17674 Mahoning Avenue, Suite B, Lake Milton, OH 44429 | [sources] | |||
| Postal code | 44429 | [sources] | |||
| State | OH | [sources] | |||
| Street address | 17674 Mahoning Avenue, Suite B | [sources] | |||
| Last change | Last processed | First seen | |||
Medical providers excluded or suspended from Ohio's Medicaid program.
United States of America · ODM
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