FOUNTAIN OF YOUTH, LLC

TERRE HAUTE, IN
NPI1316205115
Doing Business AsSEELYVILLE FAMILY PRACTICE
Entity TypeOrganization
Authorized ContactSHERRI JERNBERG
Owner/Operator
812-239-4090
Organization Subpart ?No
Primary Taxonomy261Q00000X Clinic/Center
(Licence: IN  71002624A)
Enumeration Date2012-04-30
Last Update Date2012-04-30
Business Address
FOUNTAIN OF YOUTH, LLC
8810 WABASH AVE
TERRE HAUTE, IN 47803-3908
Phone number: 812-239-4090
Mailing Address
FOUNTAIN OF YOUTH, LLC
8810 WABASH AVE
TERRE HAUTE, IN 47803-3908
Phone number: 812-239-4090