Provider First Line Business Practice Location Address:
9525 GOLD HILL ROAD
Provider Second Line Business Practice Location Address:
SHAWNEETOWN HEALTH CARE CLINIC
Provider Business Practice Location Address City Name:
SHAWNEETOWN
Provider Business Practice Location Address State Name:
IL
Provider Business Practice Location Address Postal Code:
62984
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
618-269-3815
Provider Business Practice Location Address Fax Number:
618-269-3274
Provider Enumeration Date:
01/19/2006