Provider First Line Business Practice Location Address: 
5214 S EAST STREET
    Provider Second Line Business Practice Location Address: 
BUILDING D SUITE 1 HTS OUTPATIENT THERAPY SERVICES
    Provider Business Practice Location Address City Name: 
INDIANAPOLIS
    Provider Business Practice Location Address State Name: 
IN
    Provider Business Practice Location Address Postal Code: 
46227
    Provider Business Practice Location Address Country Code: 
US
    Provider Business Practice Location Address Telephone Number: 
800-486-4449
    Provider Business Practice Location Address Fax Number: 
317-780-3750
    Provider Enumeration Date: 
01/12/2007