Provider First Line Business Practice Location Address:
1818 E. WINDSOR ROAD
Provider Second Line Business Practice Location Address:
PSYCHIATRY/PSYCHOLOGY
Provider Business Practice Location Address City Name:
CHAMPAIGN
Provider Business Practice Location Address State Name:
IL
Provider Business Practice Location Address Postal Code:
61802
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
217-255-9700
Provider Business Practice Location Address Fax Number:
217-255-9650
Provider Enumeration Date:
07/28/2006