Provider First Line Business Practice Location Address:
1001 WEST 10TH ST OPW-M200
Provider Second Line Business Practice Location Address:
INDIANA UNIVERSITY DEPARTMENT OF MEDICINE
Provider Business Practice Location Address City Name:
INDIANAPOLIS
Provider Business Practice Location Address State Name:
IN
Provider Business Practice Location Address Postal Code:
46202-5144
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
317-630-6560
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
05/22/2008