Provider First Line Business Practice Location Address:
710 S MERIDIAN ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
PLAINVILLE
Provider Business Practice Location Address State Name:
KS
Provider Business Practice Location Address Postal Code:
67663-3211
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
785-560-3101
Provider Business Practice Location Address Fax Number:
785-527-8317
Provider Enumeration Date:
09/19/2013