UPI (Provider ID): 10016
Change Report (if Any):

Short Name: PLACES

Long Name 1: PLACES INC
Long Name 2:

Address 1: 11 WEST MONUMENT AVENUE
Address 2:

City: DAYTON
Zip Code: 45402
County: MONT

Contact: KATHY NICKELL
Title: MGR
Phone: 9374614300
FAX: 9374610443

Vendor: 10016

Reports Status: CLAIMS/BH

MACSIS Last Update Date: 12/21/2011

File Produced: 19MAY2012