Provider First Line Business Practice Location Address:
8102 CLEARVISTA PARKWAY
Provider Second Line Business Practice Location Address:
FAIRBANKS HOSPITAL
Provider Business Practice Location Address City Name:
INDIANAPOLIS
Provider Business Practice Location Address State Name:
IN
Provider Business Practice Location Address Postal Code:
46256
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
317-849-8222
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
08/29/2006