Provider First Line Business Practice Location Address:
GENNESARET FREE CLINIC 615 N ALABAMA ST
Provider Second Line Business Practice Location Address:
SUITE 136
Provider Business Practice Location Address City Name:
INDIANAPOLIS
Provider Business Practice Location Address State Name:
IN
Provider Business Practice Location Address Postal Code:
46204
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
317-639-5645
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
10/04/2019