Provider First Line Business Practice Location Address:
1432 SOUTHWEST BLVD
Provider Second Line Business Practice Location Address:
CAPTIAL REGION HOME HEALTH
Provider Business Practice Location Address City Name:
JEFFERSON CITY
Provider Business Practice Location Address State Name:
MO
Provider Business Practice Location Address Postal Code:
65102-1128
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
573-632-5752
Provider Business Practice Location Address Fax Number:
573-632-5868
Provider Enumeration Date:
02/21/2007