UPI (Provider ID): 13934
Change Report (if Any):

Short Name: COLEMAN - JEFF

Long Name 1: COLEMAN PROFESSIONAL SERVICES
Long Name 2:

Address 1: 740 NORTH 6TH STREET
Address 2:

City: STEUBENVILLE
Zip Code: 43952
County: JEFF

Contact: LISA WARD
Title: CONT
Phone: 8777963555
FAX: .

Vendor: 8215

Reports Status: CLAIMS/BH

MACSIS Last Update Date: 12/09/2015

File Produced: 14JUL2016