Provider First Line Business Practice Location Address:
201 LINCOLN WAY W
Provider Second Line Business Practice Location Address:
HEALTHY FAMILY CENTER
Provider Business Practice Location Address City Name:
MISHAWAKA
Provider Business Practice Location Address State Name:
IN
Provider Business Practice Location Address Postal Code:
46544-1905
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
574-252-3688
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
08/12/2005