Provider First Line Business Practice Location Address:
605 BIRD AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
BIRD CITY
Provider Business Practice Location Address State Name:
KS
Provider Business Practice Location Address Postal Code:
67731-0028
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
785-734-2341
Provider Business Practice Location Address Fax Number:
785-734-2489
Provider Enumeration Date:
10/09/2009