Provider First Line Business Practice Location Address:
401 E 34TH ST
Provider Second Line Business Practice Location Address:
RAPHAEL HEALTH CENTER
Provider Business Practice Location Address City Name:
INDIANAPOLIS
Provider Business Practice Location Address State Name:
IN
Provider Business Practice Location Address Postal Code:
46205-3754
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
317-860-3993
Provider Business Practice Location Address Fax Number:
317-860-3971
Provider Enumeration Date:
08/16/2006