Provider First Line Business Practice Location Address:
1 PROVIDENCE PL, PROVIDENCE HEALTH CARE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
ST MARY-OF-THE-WOODS
Provider Business Practice Location Address State Name:
IN
Provider Business Practice Location Address Postal Code:
47876
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
812-535-4001
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
05/19/2021