Provider First Line Business Practice Location Address:
2100 N SUMMIT ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
ARKANSAS CITY
Provider Business Practice Location Address State Name:
KS
Provider Business Practice Location Address Postal Code:
67005-3855
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
620-441-0283
Provider Business Practice Location Address Fax Number:
620-441-0887
Provider Enumeration Date:
09/01/2011