Provider First Line Business Practice Location Address:
OCCUPATIONAL AND SPEECH THERAPY SISTERS OF PROVIDENCE
Provider Second Line Business Practice Location Address:
3301 ST. MARY'S RD
Provider Business Practice Location Address City Name:
ST. MARY OF THE WOODS
Provider Business Practice Location Address State Name:
IN
Provider Business Practice Location Address Postal Code:
47876
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
812-535-1095
Provider Business Practice Location Address Fax Number:
812-535-1004
Provider Enumeration Date:
07/23/2007