Provider First Line Business Practice Location Address:
1220 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:
46241-3127
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
317-243-8251
Provider Business Practice Location Address Fax Number:
317-243-5744
Provider Enumeration Date:
02/19/2007