UPI (Provider ID): 10363
Change Report (if Any):

Short Name: APPLEWOOD-LORAI

Long Name 1: APPLEWOOD CENTER
Long Name 2:

Address 1: 5255 NORTH ABBE ROAD SUITE 1
Address 2:

City: SHEFFIELD VILLAGE
Zip Code: 44035
County: LORA

Contact: SUE STJOHN
Title: FINDR
Phone: 4409349930
FAX: 4409349645

Vendor: 10117

Reports Status: CLAIMS/NO

MACSIS Last Update Date: 11/29/2011

File Produced: 14JUL2016