Provider First Line Business Practice Location Address:
101 NORTH B STREET
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
LA HARPE
Provider Business Practice Location Address State Name:
IL
Provider Business Practice Location Address Postal Code:
61450-0547
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
217-659-3222
Provider Business Practice Location Address Fax Number:
217-659-3017
Provider Enumeration Date:
02/28/2007