Provider First Line Business Practice Location Address:
4415 AICHOLTZ ROAD
Provider Second Line Business Practice Location Address:
MERCY HEALTH - EASTGATE MEDICAL CENTER
Provider Business Practice Location Address City Name:
CINCINNATI
Provider Business Practice Location Address State Name:
OH
Provider Business Practice Location Address Postal Code:
45245
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
513-947-1130
Provider Business Practice Location Address Fax Number:
513-947-8541
Provider Enumeration Date:
08/11/2005