Provider First Line Business Practice Location Address:
3000 N HIGH SCHOOL RD
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:
46224-2002
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
513-435-5641
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
03/04/2026