Provider First Line Business Practice Location Address:
201 SOUTH 14TH ST.
Provider Second Line Business Practice Location Address:
HERRIN HOSPITAL RESPIRATORY DISEASE CLINIC
Provider Business Practice Location Address City Name:
HERRIN
Provider Business Practice Location Address State Name:
IL
Provider Business Practice Location Address Postal Code:
62948
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
618-942-2171
Provider Business Practice Location Address Fax Number:
618-351-4945
Provider Enumeration Date:
04/20/2006