Provider First Line Business Mailing Address:
237 WILLIAM HOWARD TAFT, PHYS. DIV.
Provider Second Line Business Mailing Address:
2ND FL, CBO2-3, ATTN: CREDENTIALING
Provider Business Mailing Address City Name:
CINCINNATI
Provider Business Mailing Address State Name:
OH
Provider Business Mailing Address Postal Code:
45219-2906
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
513-792-7443
Provider Business Mailing Address Fax Number:
513-577-5177