Provider First Line Business Practice Location Address:
1902 S US HIGHWAY 59
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
PARSONS
Provider Business Practice Location Address State Name:
KS
Provider Business Practice Location Address Postal Code:
67357-4948
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
620-421-4880
Provider Business Practice Location Address Fax Number:
620-421-9544
Provider Enumeration Date:
07/07/2005