Provider First Line Business Practice Location Address:
400 6TH ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
WAMEGO
Provider Business Practice Location Address State Name:
KS
Provider Business Practice Location Address Postal Code:
66547-1835
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
785-844-0078
Provider Business Practice Location Address Fax Number:
785-456-9520
Provider Enumeration Date:
01/05/2020