Provider First Line Business Practice Location Address:
950 W WALNUT ST
Provider Second Line Business Practice Location Address:
DIVISION OF NEPHROLOGY, R2 BUILDING ROOM 202
Provider Business Practice Location Address City Name:
INDIANAPOLIS
Provider Business Practice Location Address State Name:
IN
Provider Business Practice Location Address Postal Code:
46202-5188
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
317-274-7453
Provider Business Practice Location Address Fax Number:
317-274-8575
Provider Enumeration Date:
09/17/2008