UPI (Provider ID): 12421
Change Report (if Any):

Short Name: GOODWILL MIAMI

Long Name 1: GOODWILL INDUSTRIES OF THE
Long Name 2: MIAMI VALLEY EASTER SEALS

Address 1: 1511 KUNTZ ROAD
Address 2:

City: DAYTON
Zip Code: 45404
County: MONT

Contact: AMY LUTTRELL
Title: EXDIR
Phone: 9374614800
FAX: 9374619578

Vendor: 12421

Reports Status: CLAIMS/NO

MACSIS Last Update Date: 11/29/2011

File Produced: 19MAY2012