UPI (Provider ID): 3423
Change Report (if Any):

Short Name: PROJECT IMPACT

Long Name 1: PROJECT IMPACT DAYTON INC
Long Name 2:

Address 1: 115 EAST THIRD STREET 4TH FL
Address 2:

City: DAYTON
Zip Code: 45402
County: MONT

Contact: MICHAEL WILLIAMS
Title:
Phone: 9372785683
FAX: 9372224640

Vendor: 3423

Reports Status: CLAIMS/NO

MACSIS Last Update Date: 02/11/2012

File Produced: 19MAY2012