Provider First Line Business Practice Location Address:
1500 NEELEY AVE
Provider Second Line Business Practice Location Address:
BALL STATE UNIVERSITY STUDENT HEALTH CENTER
Provider Business Practice Location Address City Name:
MUNCIE
Provider Business Practice Location Address State Name:
IN
Provider Business Practice Location Address Postal Code:
47306-0001
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
765-285-1254
Provider Business Practice Location Address Fax Number:
765-285-3512
Provider Enumeration Date:
12/27/2006