Provider First Line Business Practice Location Address:
2001 W 86TH ST.
Provider Second Line Business Practice Location Address:
ST. VINCENT EMERGENCY PHYSICIANS, INC
Provider Business Practice Location Address City Name:
INDPLS
Provider Business Practice Location Address State Name:
IN
Provider Business Practice Location Address Postal Code:
46260-1902
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
317-802-3140
Provider Business Practice Location Address Fax Number:
317-870-0499
Provider Enumeration Date:
11/22/2005