Provider First Line Business Practice Location Address:
101 N UNIVERSITY
Provider Second Line Business Practice Location Address:
ISU HEALTH SERVICE PHARMACY
Provider Business Practice Location Address City Name:
NORMAL
Provider Business Practice Location Address State Name:
IL
Provider Business Practice Location Address Postal Code:
61790-2540
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
309-438-8713
Provider Business Practice Location Address Fax Number:
309-438-7569
Provider Enumeration Date:
11/22/2006