Provider First Line Business Practice Location Address:
5410 S HIGH SCHOOL RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
INDIANAPOLIS
Provider Business Practice Location Address State Name:
IN
Provider Business Practice Location Address Postal Code:
46221-4044
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
317-856-5400
Provider Business Practice Location Address Fax Number:
317-849-6632
Provider Enumeration Date:
04/18/2006