Provider First Line Business Practice Location Address:
191 IOWA BLVD
Provider Second Line Business Practice Location Address:
WRIGHT MEMORIAL HOSPITAL
Provider Business Practice Location Address City Name:
TRENTON
Provider Business Practice Location Address State Name:
MO
Provider Business Practice Location Address Postal Code:
64683-8343
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
660-358-5700
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
04/09/2008