Provider First Line Business Practice Location Address:
2549 E COUNTY ROAD 700 S
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
CARLISLE
Provider Business Practice Location Address State Name:
IN
Provider Business Practice Location Address Postal Code:
47838-8245
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
812-398-4046
Provider Business Practice Location Address Fax Number:
812-398-9094
Provider Enumeration Date:
08/04/2006