Provider First Line Business Practice Location Address:
238 S CONGRESS ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
RUSHVILLE
Provider Business Practice Location Address State Name:
IL
Provider Business Practice Location Address Postal Code:
62681-1465
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
217-243-1101
Provider Business Practice Location Address Fax Number:
217-243-5003
Provider Enumeration Date:
03/19/2007