Provider First Line Business Practice Location Address:
10455 ORTHOPAEDIC DR
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
NEWBURGH
Provider Business Practice Location Address State Name:
IN
Provider Business Practice Location Address Postal Code:
47630-7955
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
812-424-9291
Provider Business Practice Location Address Fax Number:
812-421-2722
Provider Enumeration Date:
05/27/2005