Provider First Line Business Practice Location Address:
1592 N 146TH RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
CONCORDIA
Provider Business Practice Location Address State Name:
KS
Provider Business Practice Location Address Postal Code:
66901-6894
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
785-243-5026
Provider Business Practice Location Address Fax Number:
785-243-5026
Provider Enumeration Date:
08/20/2014