Provider First Line Business Practice Location Address:
355 W. 16TH STREET
Provider Second Line Business Practice Location Address:
IU HEALTH NEUROSCIENCE CENTER, SUITE 4800
Provider Business Practice Location Address City Name:
INDIANAPOLIS
Provider Business Practice Location Address State Name:
IN
Provider Business Practice Location Address Postal Code:
46202
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
317-963-7288
Provider Business Practice Location Address Fax Number:
317-968-1068
Provider Enumeration Date:
04/14/2026