UPI (Provider ID): 10039
Change Report (if Any):

Short Name: LIBERTY CENTER

Long Name 1: LIBERTY CENTER CONNECTIONS
Long Name 2:

Address 1: 104 SPINK STREET 1ST FLOOR
Address 2:

City: WOOSTER
Zip Code: 44691
County: WAYN

Contact: MAC HAWKINS
Title:
Phone: 3302636021
FAX: 3302626245

Vendor: 10039

Reports Status: CLAIMS/BH

MACSIS Last Update Date: 02/06/2012

File Produced: 19MAY2012