Provider First Line Business Practice Location Address:
25 W 1ST ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
CAMPBELLSBURG
Provider Business Practice Location Address State Name:
IN
Provider Business Practice Location Address Postal Code:
47108-9146
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
812-755-4443
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
04/19/2006