Provider First Line Business Practice Location Address:
101 N GIRLS SCHOOL RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
INDIANAPOLIS
Provider Business Practice Location Address State Name:
IN
Provider Business Practice Location Address Postal Code:
46214-3963
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
317-247-0201
Provider Business Practice Location Address Fax Number:
317-481-6756
Provider Enumeration Date:
06/23/2005