Provider First Line Business Practice Location Address:
720 MEDICAL CENTER DR
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
NEWTON
Provider Business Practice Location Address State Name:
KS
Provider Business Practice Location Address Postal Code:
67114-8778
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
316-283-6103
Provider Business Practice Location Address Fax Number:
907-258-1257
Provider Enumeration Date:
01/27/2006