Provider First Line Business Practice Location Address:
5259 N DAVID STREET
Provider Second Line Business Practice Location Address:
LAURENCE COMMUNITY WELLNESS CENTER
Provider Business Practice Location Address City Name:
INDIANAPOLIS
Provider Business Practice Location Address State Name:
IN
Provider Business Practice Location Address Postal Code:
46226
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
317-423-8425
Provider Business Practice Location Address Fax Number:
317-423-8429
Provider Enumeration Date:
01/17/2007