Provider First Line Business Practice Location Address:
1900 MEDICAL ARTS DR
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
HUNTINGBURG
Provider Business Practice Location Address State Name:
IN
Provider Business Practice Location Address Postal Code:
47542-9521
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
812-683-2121
Provider Business Practice Location Address Fax Number:
812-683-6485
Provider Enumeration Date:
12/13/2006