Provider First Line Business Practice Location Address:
404 W MAIN ST
Provider Second Line Business Practice Location Address:
PATHOLOGY DEPARTMENT
Provider Business Practice Location Address City Name:
CARBONDALE
Provider Business Practice Location Address State Name:
IL
Provider Business Practice Location Address Postal Code:
62901-2904
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
618-549-0721
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
12/07/2005