UPI (Provider ID): 10231
Change Report (if Any):

Short Name: PROJECT WOMAN

Long Name 1: PROJECT WOMAN
Long Name 2:

Address 1: 1316 EAST HIGH STREET
Address 2:

City: SPRINGFIELD
Zip Code: 45505
County: CLAR

Contact: LISA HEARNS
Title:
Phone: 9373253707
FAX: 9373285324

Vendor: 10231

Reports Status: CLAIMS/BH

MACSIS Last Update Date: 12/20/2011

File Produced: 19MAY2012