UPI (Provider ID): 12898
Change Report (if Any):

Short Name: WOMANLINE

Long Name 1: WOMANLINE OF DAYTON INC
Long Name 2:

Address 1: 301 EAST SIXTH STREET
Address 2:

City: DAYTON
Zip Code: 45402
County: MONT

Contact: JOHN O'BRYAN
Title: CEO
Phone: 9372233446
FAX: 9372233484

Vendor: 12898

Reports Status: CLAIMS/NO

MACSIS Last Update Date: 12/10/2011

File Produced: 19MAY2012