Provider First Line Business Practice Location Address:
221 N 11TH ST
Provider Second Line Business Practice Location Address:
HCH - SALVATION ARMY - 6TH ST.
Provider Business Practice Location Address City Name:
SPRINGFIELD
Provider Business Practice Location Address State Name:
IL
Provider Business Practice Location Address Postal Code:
62703-1003
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
217-788-2300
Provider Business Practice Location Address Fax Number:
217-788-2343
Provider Enumeration Date:
01/08/2007