Provider First Line Business Practice Location Address:
216 S. HOWARD ST.
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
KIMBALL
Provider Business Practice Location Address State Name:
NE
Provider Business Practice Location Address Postal Code:
69145-1265
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
308-235-0017
Provider Business Practice Location Address Fax Number:
308-235-0018
Provider Enumeration Date:
06/13/2006