Provider First Line Business Practice Location Address:
1401 CHURCHILL ST.
Provider Second Line Business Practice Location Address:
CRYSTAL RIVER NURSING
Provider Business Practice Location Address City Name:
WAUPACA
Provider Business Practice Location Address State Name:
WI
Provider Business Practice Location Address Postal Code:
54981
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
715-258-8131
Provider Business Practice Location Address Fax Number:
715-258-0179
Provider Enumeration Date:
09/02/2010