MACSIS Provider (PROVF) Summary Sheet

UPI (Provider ID): 1997
Change Report (if Any):

Short Name: ALT PATHS INC

Long Name 1: ALTERNATIVE PATHS INC
Long Name 2:

Address 1: 246 NORTHLAND DRIVE SUITE 200A
Address 2:

City: MEDINA
Zip Code: 44256
County: MEDI

Contact: TIMOTHY A GILROY
Title: FINOF
Phone: 3307259195
FAX: 3307259187

Vendor: 1997

Reports Status: CLAIMS/BH

MACSIS Last Update Date: 12/12/2011

File Produced: 19MAY2012