Provider First Line Business Practice Location Address:
920 E KANSAS AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SMITH CENTER
Provider Business Practice Location Address State Name:
KS
Provider Business Practice Location Address Postal Code:
66967
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
785-282-6722
Provider Business Practice Location Address Fax Number:
785-282-6387
Provider Enumeration Date:
01/26/2018