Provider First Line Business Practice Location Address:
502 S WASHINGTON AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SABETHA
Provider Business Practice Location Address State Name:
KS
Provider Business Practice Location Address Postal Code:
66534-2625
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
785-284-3010
Provider Business Practice Location Address Fax Number:
785-284-3136
Provider Enumeration Date:
07/28/2006