Provider First Line Business Practice Location Address:
3901 SOUTH 7TH ST
Provider Second Line Business Practice Location Address:
DIETITIAN'S OFFICE 4TH FLOOR
Provider Business Practice Location Address City Name:
TERRE HAUTE
Provider Business Practice Location Address State Name:
IN
Provider Business Practice Location Address Postal Code:
47802
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
812-237-1161
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
03/28/2019