Provider First Line Business Practice Location Address:
2702 E KEMPER RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
CINCINNATI
Provider Business Practice Location Address State Name:
OH
Provider Business Practice Location Address Postal Code:
45241-1818
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
213-771-2233
Provider Business Practice Location Address Fax Number:
513-612-3572
Provider Enumeration Date:
02/20/2007