Provider First Line Business Practice Location Address:
1101 E. PRESCOTT AVE.
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SALINA
Provider Business Practice Location Address State Name:
KS
Provider Business Practice Location Address Postal Code:
67401
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
785-404-1712
Provider Business Practice Location Address Fax Number:
785-404-1778
Provider Enumeration Date:
09/13/2006