Provider First Line Business Practice Location Address: 
1801 SENATE BLVD
    Provider Second Line Business Practice Location Address: 
SUITE 3100
    Provider Business Practice Location Address City Name: 
INDIANAPOLIS
    Provider Business Practice Location Address State Name: 
IN
    Provider Business Practice Location Address Postal Code: 
46202-1228
    Provider Business Practice Location Address Country Code: 
US
    Provider Business Practice Location Address Telephone Number: 
317-962-9700
    Provider Business Practice Location Address Fax Number: 
317-962-5360
    Provider Enumeration Date: 
07/26/2006