Organization
SOUTHERN OHIO RECOVERY GROUP, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RACHELE SMITH (PRACTICE MANAGER)
(513) 377-9374
Entity
Organization
Contact information
Practice address
9403 KENWOOD RD, BLUE ASH, OH 45242-6895
(513) 543-6600
Mailing address
9403 KENWOOD RD, BLUE ASH, OH 45242-6895
(513) 543-6600
Taxonomy
Speciality
Code
Description
License number
State
207QA0401X
Addiction Medicine (Family Medicine) Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
31094333
—
OH
Enumeration date
09/10/2017
Last updated
03/17/2018
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