Provider First Line Business Practice Location Address:
2409 SOUTH ALVERNO ROAD
Provider Second Line Business Practice Location Address:
HOLY FAMILY HEALTH CLINIC
Provider Business Practice Location Address City Name:
MANITOWOC
Provider Business Practice Location Address State Name:
WI
Provider Business Practice Location Address Postal Code:
54220-9302
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
920-682-7728
Provider Business Practice Location Address Fax Number:
920-682-4243
Provider Enumeration Date:
12/21/2005