Provider First Line Business Practice Location Address:
216 WEST BIRCH
Provider Second Line Business Practice Location Address:
SCKRMC
Provider Business Practice Location Address City Name:
ARKANSAS CITY
Provider Business Practice Location Address State Name:
KS
Provider Business Practice Location Address Postal Code:
67005
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
620-442-2500
Provider Business Practice Location Address Fax Number:
620-441-5968
Provider Enumeration Date:
10/23/2006