Provider First Line Business Practice Location Address:
1919 WEST TAYLOR - 650 AHSB
Provider Second Line Business Practice Location Address:
DEPARTMENT OF KINESIOLOGY AN
Provider Business Practice Location Address City Name:
CHICAGO
Provider Business Practice Location Address State Name:
IL
Provider Business Practice Location Address Postal Code:
60612
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
708-507-0154
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
10/10/2012