Provider First Line Business Practice Location Address:
964 MEZZANINE DR
Provider Second Line Business Practice Location Address:
PLANNED PARENTHOOD OF INDIANA AND KENTUCKY
Provider Business Practice Location Address City Name:
LAFAYETTE
Provider Business Practice Location Address State Name:
IN
Provider Business Practice Location Address Postal Code:
47905-8631
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
765-446-8078
Provider Business Practice Location Address Fax Number:
765-446-8160
Provider Enumeration Date:
10/15/2007