Provider First Line Business Practice Location Address:
700 MEDICAL CENTER DR.
Provider Second Line Business Practice Location Address:
SUITE 240
Provider Business Practice Location Address City Name:
NEWTON
Provider Business Practice Location Address State Name:
KS
Provider Business Practice Location Address Postal Code:
67114
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
316-283-4005
Provider Business Practice Location Address Fax Number:
316-283-6664
Provider Enumeration Date:
03/20/2006