Provider First Line Business Practice Location Address:
7120 S US HIGHWAY 231
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:
47542-9319
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
812-683-2431
Provider Business Practice Location Address Fax Number:
812-683-4603
Provider Enumeration Date:
08/25/2006