Provider First Line Business Practice Location Address:
1001 KNAPP ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
CHETEK
Provider Business Practice Location Address State Name:
WI
Provider Business Practice Location Address Postal Code:
54728
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
715-924-3337
Provider Business Practice Location Address Fax Number:
715-924-2376
Provider Enumeration Date:
03/24/2008