Provider First Line Business Practice Location Address:
650 W STATE STREET
Provider Second Line Business Practice Location Address:
WINNEBAGO COUNTY JAIL MEDICAL UNIT
Provider Business Practice Location Address City Name:
ROCKFORD
Provider Business Practice Location Address State Name:
IL
Provider Business Practice Location Address Postal Code:
61102-0000
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
815-319-6630
Provider Business Practice Location Address Fax Number:
815-962-6425
Provider Enumeration Date:
02/14/2011