Provider First Line Business Practice Location Address:
212 S MAIN ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
NEW CASTLE
Provider Business Practice Location Address State Name:
IN
Provider Business Practice Location Address Postal Code:
47362-4215
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
765-529-5226
Provider Business Practice Location Address Fax Number:
765-529-1556
Provider Enumeration Date:
10/02/2006