Provider First Line Business Practice Location Address:
374 E. GRAND AVE.
Provider Second Line Business Practice Location Address:
SIUC STUDENT HEALTH CENTER
Provider Business Practice Location Address City Name:
CARBONDALE
Provider Business Practice Location Address State Name:
IL
Provider Business Practice Location Address Postal Code:
62901
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
618-453-1292
Provider Business Practice Location Address Fax Number:
618-453-4290
Provider Enumeration Date:
02/27/2007