UPI (Provider ID): 10025
Change Report (if Any):

Short Name: ICAN

Long Name 1: ICAN INC
Long Name 2:

Address 1: 1214 MARKET AVENUE NORTH
Address 2:

City: CANTON
Zip Code: 44714
County: STAR

Contact: MARYELLEN HESS
Title:
Phone: 3304559100
FAX: 3304554702

Vendor: 10025

Reports Status: CLAIMS/NO

MACSIS Last Update Date: 12/16/2011

File Produced: 19MAY2012