Provider First Line Business Practice Location Address:
421 S CAMPUS AVE
Provider Second Line Business Practice Location Address:
195 HEALTH SERVICES CENTER
Provider Business Practice Location Address City Name:
OXFORD
Provider Business Practice Location Address State Name:
OH
Provider Business Practice Location Address Postal Code:
45056-2400
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
513-529-4634
Provider Business Practice Location Address Fax Number:
513-529-2975
Provider Enumeration Date:
01/29/2007