Provider First Line Business Practice Location Address:
1606 N 7TH STREET
Provider Second Line Business Practice Location Address:
UNION HOSPITAL
Provider Business Practice Location Address City Name:
TERRE HAUTE
Provider Business Practice Location Address State Name:
IN
Provider Business Practice Location Address Postal Code:
47804-2780
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
812-238-4644
Provider Business Practice Location Address Fax Number:
812-238-7837
Provider Enumeration Date:
10/19/2005