Provider First Line Business Practice Location Address:
1701 W CURTIS ROAD
Provider Second Line Business Practice Location Address:
FAMILY MEDICINE/CONVENIENT CARE
Provider Business Practice Location Address City Name:
CHAMPAIGN
Provider Business Practice Location Address State Name:
IL
Provider Business Practice Location Address Postal Code:
61822
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
217-365-6201
Provider Business Practice Location Address Fax Number:
217-326-1234
Provider Enumeration Date:
10/19/2006