Provider First Line Business Practice Location Address:
400 OSAGE ST.
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
MANHATTAN
Provider Business Practice Location Address State Name:
KS
Provider Business Practice Location Address Postal Code:
66502
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
785-539-9600
Provider Business Practice Location Address Fax Number:
785-537-6280
Provider Enumeration Date:
10/03/2006