Provider First Line Business Practice Location Address:
2101 US HIGHWAY 50 BYP
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
DODGE CITY
Provider Business Practice Location Address State Name:
KS
Provider Business Practice Location Address Postal Code:
67801-2230
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
620-227-8566
Provider Business Practice Location Address Fax Number:
620-225-5824
Provider Enumeration Date:
09/26/2008