Provider First Line Business Practice Location Address:
1 LUCINDA AVE.
Provider Second Line Business Practice Location Address:
NIU SPEECH-LANGUAGE AND HEARING CLINIC
Provider Business Practice Location Address City Name:
DEKALB
Provider Business Practice Location Address State Name:
IL
Provider Business Practice Location Address Postal Code:
60115-2899
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
815-753-6508
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
12/04/2006