Provider First Line Business Practice Location Address:
2870 SOUTH LIMA ROAD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
KENDALVILLE
Provider Business Practice Location Address State Name:
IN
Provider Business Practice Location Address Postal Code:
46755
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
260-349-1000
Provider Business Practice Location Address Fax Number:
280-349-1250
Provider Enumeration Date:
09/07/2007