Provider First Line Business Practice Location Address:
415 HEALTH DEPARTMENT RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
MURPHYSBORO
Provider Business Practice Location Address State Name:
IL
Provider Business Practice Location Address Postal Code:
62966-6108
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
618-684-3143
Provider Business Practice Location Address Fax Number:
618-684-6023
Provider Enumeration Date:
09/14/2006