Provider First Line Business Practice Location Address:
602 N JEFFERSON ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
JUNCTION CITY
Provider Business Practice Location Address State Name:
KS
Provider Business Practice Location Address Postal Code:
66441-0821
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
785-762-4800
Provider Business Practice Location Address Fax Number:
785-762-2136
Provider Enumeration Date:
12/08/2005