MACSIS Provider (PROVF) Summary Sheet

UPI (Provider ID): 12424
Change Report (if Any):

Short Name: RECOVERY OPTION

Long Name 1: RECOVERY OPTIONS INC
Long Name 2:

Address 1: 470 EAST MARKET STREET
Address 2:

City: ALLIANCE
Zip Code: 43215
County: STAR

Contact: AL LOTZ
Title:
Phone: 3308234566
FAX: 3308236183

Vendor: 12424

Reports Status: NO CLAIMS/

MACSIS Last Update Date: 11/29/2011

File Produced: 19MAY2012