Provider First Line Business Practice Location Address:
1600 CHARLES PLACE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
MANHATTAN
Provider Business Practice Location Address State Name:
KS
Provider Business Practice Location Address Postal Code:
66502-2750
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
785-539-8900
Provider Business Practice Location Address Fax Number:
785-539-4425
Provider Enumeration Date:
03/02/2010