Provider First Line Business Practice Location Address:
234 GOODMAN STREET
Provider Second Line Business Practice Location Address:
THE UNIVERSITY HOSPITAL, DEPARTMENT OF PSYCHIATRY
Provider Business Practice Location Address City Name:
CINCINNATI
Provider Business Practice Location Address State Name:
OH
Provider Business Practice Location Address Postal Code:
45219
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
513-410-2385
Provider Business Practice Location Address Fax Number:
513-558-0731
Provider Enumeration Date:
10/31/2005