Provider First Line Business Practice Location Address:
1525 ELM ST
Provider Second Line Business Practice Location Address:
ELM STREET 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:
45202-6957
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
513-352-3092
Provider Business Practice Location Address Fax Number:
513-352-1429
Provider Enumeration Date:
12/20/2005