Provider First Line Business Practice Location Address:
16 N CALE ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
POSEYVILLE
Provider Business Practice Location Address State Name:
IN
Provider Business Practice Location Address Postal Code:
47633
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
812-874-2235
Provider Business Practice Location Address Fax Number:
812-874-2247
Provider Enumeration Date:
11/23/2007