Provider First Line Business Practice Location Address:
601 STADIUM MALL DRIVE
Provider Second Line Business Practice Location Address:
PURDUE UNIVERSITY STUDENT HEALTH CENTER, 2ND FLOOR
Provider Business Practice Location Address City Name:
WEST LAFAYETTE
Provider Business Practice Location Address State Name:
IN
Provider Business Practice Location Address Postal Code:
47907
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
765-494-6995
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
01/24/2018