Provider First Line Business Practice Location Address:
6231 SOUTH US HIGHWAY 31
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
FRANKLIN
Provider Business Practice Location Address State Name:
IN
Provider Business Practice Location Address Postal Code:
46131
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
812-526-2611
Provider Business Practice Location Address Fax Number:
812-526-4108
Provider Enumeration Date:
02/07/2007