Provider First Line Business Practice Location Address:
550 UNIVERSITY BLVD RM UH-3195
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
INDIANAPOLIS
Provider Business Practice Location Address State Name:
IN
Provider Business Practice Location Address Postal Code:
46202-5149
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
317-274-8300
Provider Business Practice Location Address Fax Number:
317-274-0965
Provider Enumeration Date:
04/09/2020