Provider First Line Business Practice Location Address:
700 MEDICAL CENTER DR
Provider Second Line Business Practice Location Address:
SUITE 140
Provider Business Practice Location Address City Name:
NEWTON
Provider Business Practice Location Address State Name:
KS
Provider Business Practice Location Address Postal Code:
67114-9013
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
316-804-6100
Provider Business Practice Location Address Fax Number:
316-804-6123
Provider Enumeration Date:
06/27/2006