Provider First Line Business Practice Location Address:
1365 DOUGLAS DR
Provider Second Line Business Practice Location Address:
COLLEGE OF APPLIED SCIENCES/SCHOOL OF ALLIED HEALTH
Provider Business Practice Location Address City Name:
CARBONDALE
Provider Business Practice Location Address State Name:
IL
Provider Business Practice Location Address Postal Code:
62901-6615
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
618-453-7241
Provider Business Practice Location Address Fax Number:
618-453-7020
Provider Enumeration Date:
03/27/2008