Provider First Line Business Practice Location Address:
BALL STATE UNIV
Provider Second Line Business Practice Location Address:
2000 W. UNIVERSITY AVE.
Provider Business Practice Location Address City Name:
MUNCIE
Provider Business Practice Location Address State Name:
IN
Provider Business Practice Location Address Postal Code:
47306-0270
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
765-285-5039
Provider Business Practice Location Address Fax Number:
765-285-5610
Provider Enumeration Date:
07/10/2014