Provider First Line Business Practice Location Address:
75 CAMO CLAD DR
Provider Second Line Business Practice Location Address:
PULASKI COUNTY AMBULANCE
Provider Business Practice Location Address City Name:
MOUNDS
Provider Business Practice Location Address State Name:
IL
Provider Business Practice Location Address Postal Code:
62964
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
618-342-6209
Provider Business Practice Location Address Fax Number:
618-342-6254
Provider Enumeration Date:
09/22/2006