Provider First Line Business Practice Location Address:
1180 CHANDLER DRIVE
Provider Second Line Business Practice Location Address:
ESSENTIA HEALTH SPOONER CLINIC
Provider Business Practice Location Address City Name:
SPOONER
Provider Business Practice Location Address State Name:
WI
Provider Business Practice Location Address Postal Code:
54801-2204
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
715-635-2151
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
11/17/2007