Provider First Line Business Practice Location Address:
224 E. DOUGLAS AVE.
Provider Second Line Business Practice Location Address:
SUITE 400 C/O ANESTHESIA CONSULTING SERVICES
Provider Business Practice Location Address City Name:
WICHITA
Provider Business Practice Location Address State Name:
KS
Provider Business Practice Location Address Postal Code:
67202
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
316-264-1757
Provider Business Practice Location Address Fax Number:
316-264-1907
Provider Enumeration Date:
02/04/2009