Provider First Line Business Practice Location Address:
700 S 14TH ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
NEW CASTLE
Provider Business Practice Location Address State Name:
IN
Provider Business Practice Location Address Postal Code:
47362-3341
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
765-521-0832
Provider Business Practice Location Address Fax Number:
765-521-0853
Provider Enumeration Date:
12/19/2006