Provider First Line Business Practice Location Address:
1706 MEDICAL ARTS DR STE 3
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
HUNTINGBURG
Provider Business Practice Location Address State Name:
IN
Provider Business Practice Location Address Postal Code:
47542-9391
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
812-683-4900
Provider Business Practice Location Address Fax Number:
812-683-3206
Provider Enumeration Date:
10/03/2006