Provider First Line Business Practice Location Address:
1614 N. LEBANON ST.
Provider Second Line Business Practice Location Address:
INTEGRATIVE WELLNESS, LLC
Provider Business Practice Location Address City Name:
LEBANON
Provider Business Practice Location Address State Name:
IN
Provider Business Practice Location Address Postal Code:
46052
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
765-680-0071
Provider Business Practice Location Address Fax Number:
765-680-0468
Provider Enumeration Date:
04/10/2015