UPI (Provider ID): 10028
Change Report (if Any):

Short Name: BLICK CLINIC

Long Name 1: BLICK CLINIC INC
Long Name 2:

Address 1: 640 WEST MARKET STREET
Address 2:

City: AKRON
Zip Code: 443031465
County: SUMM

Contact: KATRINA PEYTON
Title:
Phone: 3307625425
FAX: 3307624019

Vendor: 10028

Reports Status: CLAIMS/NO

MACSIS Last Update Date: 12/29/2011

File Produced: 14JUL2016