Provider First Line Business Practice Location Address:
330 ARKANSAS ST
Provider Second Line Business Practice Location Address:
SUITE 202
Provider Business Practice Location Address City Name:
LAWRENCE
Provider Business Practice Location Address State Name:
KS
Provider Business Practice Location Address Postal Code:
66044-1335
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
785-505-2200
Provider Business Practice Location Address Fax Number:
785-505-5237
Provider Enumeration Date:
06/16/2009