UPI (Provider ID): 3285
Change Report (if Any):

Short Name: ADOL PREG-MARI

Long Name 1: MARION ADOLESCENT PREGNANCY
Long Name 2: PROGRAM

Address 1: 498 NORTH MAIN STREET
Address 2:

City: MARION
Zip Code: 43302
County: MARI

Contact: CHRISTINE HAAS
Title: EX DR
Phone: 7403878336
FAX: 7403821339

Vendor: 3285

Reports Status: NO CLAIMS/

MACSIS Last Update Date: 11/29/2011

File Produced: 19MAY2012