Provider First Line Business Practice Location Address:
808 N 8TH ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SENECA
Provider Business Practice Location Address State Name:
KS
Provider Business Practice Location Address Postal Code:
66538-1419
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
785-336-2156
Provider Business Practice Location Address Fax Number:
785-336-3881
Provider Enumeration Date:
04/15/2006