Provider First Line Business Practice Location Address:
2620 OLD MAIN HILL
Provider Second Line Business Practice Location Address:
NORTHERN ILLINOIS UNIV SPEECH-LANGUAGE-HEARING CLINIC
Provider Business Practice Location Address City Name:
LOGAN
Provider Business Practice Location Address State Name:
UT
Provider Business Practice Location Address Postal Code:
84321
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
435-797-3701
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
10/17/2006