Provider First Line Business Practice Location Address:
1451 N GARDNER ST
Provider Second Line Business Practice Location Address:
PHOENIX EMERGENCY SERVICES OF SCOTT COUNTY, LLC
Provider Business Practice Location Address City Name:
SCOTTSBURG
Provider Business Practice Location Address State Name:
IN
Provider Business Practice Location Address Postal Code:
47170-7751
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
812-752-3456
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
06/12/2006