UPI (Provider ID): 1169
Change Report (if Any):

Short Name: TV TWIN VAL CSN

Long Name 1: TV TWIN VALLEY CSN
Long Name 2:

Address 1: 3595 SULLIVANT AVENUE
Address 2:

City: COLUMBUS
Zip Code: 43228
County: FRAN

Contact: JAMES IGNELZI
Title: CEO
Phone: 6147520333
FAX: 6147520385

Vendor: 3275

Reports Status: CLAIMS/NO

MACSIS Last Update Date: 01/12/2012

File Produced: 14JUL2016