Provider First Line Business Practice Location Address:
7240 S US HIGHWAY 231
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:
47542-9450
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
812-683-9020
Provider Business Practice Location Address Fax Number:
812-683-9024
Provider Enumeration Date:
07/05/2005