MemberID
670411
LIC
NULL
HIN
NULL
Address
2277 East Dr
City
Monte Vista
STATE
CO
AssignmentStatus
NULL
Account
NULL
Client
NULL
Affiliate
Territory
NULL
Website
NULL
RegionalSponsor
NULL
XetexCode
PR670411
SystemID
670408
ParentID
605082
CompanyCode
Premier, Inc
ClassOfTrade
Phone
(719) 852-5138
Fax
(719) 852-5333