Provider First Line Business Practice Location Address:
10006 AUBURN PARK DRIVE PREMISE HEALTH CENTER,
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
FORT WAYNE
Provider Business Practice Location Address State Name:
IN
Provider Business Practice Location Address Postal Code:
46825
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
260-247-8020
Provider Business Practice Location Address Fax Number:
260-977-2105
Provider Enumeration Date:
06/15/2006