Provider First Line Business Practice Location Address:
301 SCHOOL ST
Provider Second Line Business Practice Location Address:
301 NORTH SCHOOL STREET
Provider Business Practice Location Address City Name:
MORRISONVILLE
Provider Business Practice Location Address State Name:
IL
Provider Business Practice Location Address Postal Code:
62546-6431
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
217-526-4431
Provider Business Practice Location Address Fax Number:
217-526-4433
Provider Enumeration Date:
09/27/2011