UPI (Provider ID): 1402
Change Report (if Any):

Short Name: PROJECT CURE

Long Name 1: PROJECT CURE
Long Name 2:

Address 1: 1800 N JAMES H MCGEE BLVD
Address 2:

City: DAYTON
Zip Code: 45427
County: MONT

Contact: WILLIAM HOLLY
Title: INED
Phone: 9372623500
FAX: 9372623523

Vendor: 1402

Reports Status: CLAIMS/BH

MACSIS Last Update Date: 01/17/2012

File Produced: 19MAY2012