Provider First Line Business Practice Location Address:
715 10TH ST.
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
OSWEGO
Provider Business Practice Location Address State Name:
KS
Provider Business Practice Location Address Postal Code:
67356
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
620-795-2323
Provider Business Practice Location Address Fax Number:
620-795-2324
Provider Enumeration Date:
07/13/2006