Provider First Line Business Practice Location Address:
3820 EAST MAIN STREET
Provider Second Line Business Practice Location Address:
DANVILLE CORRECTIONAL CENTER MEDICAL DEPARTMENT
Provider Business Practice Location Address City Name:
DANVILLE
Provider Business Practice Location Address State Name:
IL
Provider Business Practice Location Address Postal Code:
61834-5796
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
217-446-0441
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
01/03/2008