UPI (Provider ID): 10248
Change Report (if Any):

Short Name: BRIDGEWAY-CLARK

Long Name 1: BRIDGEWAY INC
Long Name 2:

Address 1: 2103 CLARK AVENUE
Address 2:

City: CLEVELAND
Zip Code: 44109
County: CUYA

Contact: GENISE HERBERT
Title:
Phone: 2166871350
FAX: 2166879448

Vendor: 10509

Reports Status: NO CLAIMS/

MACSIS Last Update Date: 11/29/2011

File Produced: 14JUL2016