Provider First Line Business Practice Location Address:
MEMORIAL MEDICAL CTR
Provider Second Line Business Practice Location Address:
701 N. 1ST
Provider Business Practice Location Address City Name:
SPRINGFIELD
Provider Business Practice Location Address State Name:
IL
Provider Business Practice Location Address Postal Code:
62781-0001
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
217-788-4180
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
04/28/2008