Provider First Line Business Practice Location Address:
1125 PROFESSIONAL BLVD
Provider Second Line Business Practice Location Address:
ST MARYS SURGICARE
Provider Business Practice Location Address City Name:
EVANSVILLE
Provider Business Practice Location Address State Name:
IN
Provider Business Practice Location Address Postal Code:
47714
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
270-926-7325
Provider Business Practice Location Address Fax Number:
270-926-7325
Provider Enumeration Date:
12/03/2010