Provider First Line Business Practice Location Address:
114 W 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:
66967-2013
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
785-232-2499
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
07/13/2006