UPI (Provider ID): 12623
Change Report (if Any):

Short Name: COLEMAN - HIGH

Long Name 1: COLEMAN PROFESSIONAL SERVICES
Long Name 2:

Address 1: 320 NORTH HIGH STREET NE
Address 2: SUITE A

City: WARREN
Zip Code: 44481
County: TRUM

Contact: AMANDA GARRETT
Title: FIN
Phone: 3303931175
FAX: 3303945910

Vendor: 8215

Reports Status: CLAIMS/BH

MACSIS Last Update Date: 02/09/2012

File Produced: 14JUL2016