UPI (Provider ID): 12961
Change Report (if Any):

Short Name: CAM/WRIGHT STAT

Long Name 1: WRIGHT STATE UNIVERSITY
Long Name 2: DBA CONSUMER ADVOCACY MODEL

Address 1: 6 S PATTERSON BLVD
Address 2:

City: DAYTON
Zip Code: 45402
County: MONT

Contact: KRISTEN DUNN
Title: DIR
Phone: 9372222400
FAX: 9372227522

Vendor: 2573

Reports Status: CLAIMS/BH

MACSIS Last Update Date: 03/20/2012

File Produced: 14JUL2016