Provider First Line Business Practice Location Address:
515 NORTH SUMMIT ST.
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
ARKANSAS CITY
Provider Business Practice Location Address State Name:
KS
Provider Business Practice Location Address Postal Code:
67005
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
620-442-4850
Provider Business Practice Location Address Fax Number:
620-442-9560
Provider Enumeration Date:
09/25/2006