Provider First Line Business Practice Location Address:
LEHMBURG BUILDING
Provider Second Line Business Practice Location Address:
SUITE B
Provider Business Practice Location Address City Name:
COLUMBIA CITY
Provider Business Practice Location Address State Name:
IN
Provider Business Practice Location Address Postal Code:
46725
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
260-373-8900
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
11/01/2005