Provider First Line Business Practice Location Address:
805 S MAIN ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
PLAINVILLE
Provider Business Practice Location Address State Name:
KS
Provider Business Practice Location Address Postal Code:
67663-3315
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
785-789-2773
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
06/26/2019