Provider First Line Business Practice Location Address:
8549 S MADISON AVE
Provider Second Line Business Practice Location Address:
HCR MANOR CARE
Provider Business Practice Location Address City Name:
INDIANAPOLIS
Provider Business Practice Location Address State Name:
IN
Provider Business Practice Location Address Postal Code:
46227
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
317-881-9164
Provider Business Practice Location Address Fax Number:
317-887-4060
Provider Enumeration Date:
04/17/2007