Provider First Line Business Practice Location Address:
ONE MEMORIAL DRIVE
Provider Second Line Business Practice Location Address:
ALTON MEMORIAL HOSPITAL
Provider Business Practice Location Address City Name:
ALTON
Provider Business Practice Location Address State Name:
IL
Provider Business Practice Location Address Postal Code:
62002
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
618-463-7415
Provider Business Practice Location Address Fax Number:
314-821-2180
Provider Enumeration Date:
09/27/2006