| Company | INDIANA ACADEMY OF FAMILY PHYSICIANS |
|---|---|
| Address | 55 Monument Circle, Suite 400, INDPLS, IN, 46204, USA |
| Title | Secretary |
| Company | FAMILY PHYSICIANS HEALTH SERVICE CORPORATION OF INDIANA |
|---|---|
| Address | Indiana Academy of Family Physicians, 4847 South High School Rd., INDIANAPOLIS, IN, 46221 - 0000, USA |
| Title | Agent |