Provider First Line Business Practice Location Address:
3536 W 86TH STREET
Provider Second Line Business Practice Location Address:
DR TAVEL FAMILY EYE CARE
Provider Business Practice Location Address City Name:
INDIANAPOLIS
Provider Business Practice Location Address State Name:
IN
Provider Business Practice Location Address Postal Code:
46268-1992
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
317-876-9611
Provider Business Practice Location Address Fax Number:
317-924-9741
Provider Enumeration Date:
10/20/2005