Provider First Line Business Practice Location Address:
1200 NORTH CENTER STREET
Provider Second Line Business Practice Location Address:
LUTHERAN SOCIAL SERVICES
Provider Business Practice Location Address City Name:
BEAVER DAM
Provider Business Practice Location Address State Name:
WI
Provider Business Practice Location Address Postal Code:
53916
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
920-887-3172
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
06/06/2007