Provider First Line Business Practice Location Address:
SPRINGFIELD PSYCHOLOGICAL CENTER
Provider Second Line Business Practice Location Address:
2325 WEST WHITE OAKS DRIVE, SUITE C
Provider Business Practice Location Address City Name:
SPRINGFIELD
Provider Business Practice Location Address State Name:
IL
Provider Business Practice Location Address Postal Code:
62704-7420
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
217-793-3949
Provider Business Practice Location Address Fax Number:
217-793-3995
Provider Enumeration Date:
06/15/2006