UPI (Provider ID): 10384
Change Report (if Any):

Short Name: INTEGRATED SERV

Long Name 1: INTEGRATED SERVICE SYSTEM
Long Name 2:

Address 1: 375 RICHLAND AVENUE
Address 2: SUITE 1

City: ATHENS
Zip Code: 45701
County: ATHE

Contact: KEVIN GILLESPIE
Title: EX DR
Phone: 7405946807
FAX: 7405949967

Vendor: 10384

Reports Status: NO CLAIMS/

MACSIS Last Update Date: 11/29/2011

File Produced: 19MAY2012