EDISON LAKES UROLOGY PLYMOUTH OFFICE

PLYMOUTH, IN
NPI1033388558
Entity TypeOrganization
Authorized ContactDARRYL R BUSBY
Executive Administrator
574-296-3200
Organization Subpart ?Yes
Primary Taxonomy208800000X Urology
Enumeration Date2008-02-28
Last Update Date2008-05-30
Business Address
EDISON LAKES UROLOGY PLYMOUTH OFFICE
1919 LAKE AVE SUITE 109
PLYMOUTH, IN 46563-7830
Phone number: 574-935-2138
Mailing Address
EDISON LAKES UROLOGY PLYMOUTH OFFICE
303 S NAPPANEE ST
ELKHART, IN 46514-2066
Phone number: 574-296-3200
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