Provider First Line Business Practice Location Address:
720 POYNTZ AVE BUILDING B
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:
66502-6358
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
785-320-7331
Provider Business Practice Location Address Fax Number:
785-320-7338
Provider Enumeration Date:
02/01/2018