Provider First Line Business Practice Location Address:
1260 EAST STATE ROAD 205
Provider Second Line Business Practice Location Address:
PARKVIEW WHITLEY HOSPITAL
Provider Business Practice Location Address City Name:
COLUMBIA CITY
Provider Business Practice Location Address State Name:
IN
Provider Business Practice Location Address Postal Code:
46725
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
260-248-9530
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
06/18/2014