Provider First Line Business Practice Location Address:
1061 E SOUTHERN AVENUE
Provider Second Line Business Practice Location Address:
DIAGNOSTIC OFFICE
Provider Business Practice Location Address City Name:
INDIANAPOLIS
Provider Business Practice Location Address State Name:
IN
Provider Business Practice Location Address Postal Code:
46203
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
317-207-1986
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
07/09/2013