Provider First Line Business Practice Location Address:
101 UNITED WAY
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
FREDERIC
Provider Business Practice Location Address State Name:
WI
Provider Business Practice Location Address Postal Code:
54837
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
715-327-4253
Provider Business Practice Location Address Fax Number:
715-327-4253
Provider Enumeration Date:
12/23/2005