Provider First Line Business Practice Location Address:
1 UNIVERSITY PLZ MS 3333
Provider Second Line Business Practice Location Address:
SOUTHEAST MISSOURI STATE UNIVERSITY
Provider Business Practice Location Address City Name:
CAPE GIRARDEAU
Provider Business Practice Location Address State Name:
MO
Provider Business Practice Location Address Postal Code:
63701
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
573-651-5152
Provider Business Practice Location Address Fax Number:
573-651-2532
Provider Enumeration Date:
03/07/2011