Provider First Line Business Practice Location Address:
2889 COUNTY HIGHWAY I
Provider Second Line Business Practice Location Address:
SUITE 2
Provider Business Practice Location Address City Name:
CHIPPEWA FALLS
Provider Business Practice Location Address State Name:
WI
Provider Business Practice Location Address Postal Code:
54729-4300
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
715-720-2887
Provider Business Practice Location Address Fax Number:
715-720-2304
Provider Enumeration Date:
09/08/2008