Provider First Line Business Practice Location Address:
601 EDWIN C. MOSES BLVD.
Provider Second Line Business Practice Location Address:
SAMARITAN BEHAVIORAL HEALTH, ELIZABETH PLACE, 4TH FLOOR
Provider Business Practice Location Address City Name:
DAYTON
Provider Business Practice Location Address State Name:
OH
Provider Business Practice Location Address Postal Code:
45417-0000
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
937-276-8333
Provider Business Practice Location Address Fax Number:
937-276-8339
Provider Enumeration Date:
09/08/2005