Provider First Line Business Practice Location Address:
55 1/2 E COURT ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
FRANKLIN
Provider Business Practice Location Address State Name:
IN
Provider Business Practice Location Address Postal Code:
46131-2303
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
317-346-4000
Provider Business Practice Location Address Fax Number:
317-346-0442
Provider Enumeration Date:
06/11/2012