Provider First Line Business Practice Location Address:
240 S 7TH ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
PHILLIPSBURG
Provider Business Practice Location Address State Name:
KS
Provider Business Practice Location Address Postal Code:
67661-2700
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
785-543-5281
Provider Business Practice Location Address Fax Number:
785-543-2271
Provider Enumeration Date:
09/08/2009