UPI (Provider ID): 1452
Change Report (if Any):

Short Name: TOWNHALL II

Long Name 1: TOWNHALL II
Long Name 2:

Address 1: 155 NORTH WATER STREET
Address 2:

City: KENT
Zip Code: 44240
County: PORT

Contact: SUSAN WHITEHURST
Title: EX DR
Phone: 3306783006
FAX: 3306787558

Vendor: 1452

Reports Status: CLAIMS/BH

MACSIS Last Update Date: 04/04/2012

File Produced: 19MAY2012