Provider First Line Business Practice Location Address:
3301 BEEKMAN ST
Provider Second Line Business Practice Location Address:
MILLVALE HEALTH CENTER
Provider Business Practice Location Address City Name:
CINCINNATI
Provider Business Practice Location Address State Name:
OH
Provider Business Practice Location Address Postal Code:
45225-1205
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
513-352-3192
Provider Business Practice Location Address Fax Number:
513-352-3137
Provider Enumeration Date:
12/20/2005