Provider First Line Business Practice Location Address:
1902 S HWY 59
Provider Second Line Business Practice Location Address:
BUILDING A STE 6
Provider Business Practice Location Address City Name:
PARSONS
Provider Business Practice Location Address State Name:
KS
Provider Business Practice Location Address Postal Code:
67357
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
620-421-2460
Provider Business Practice Location Address Fax Number:
620-421-2462
Provider Enumeration Date:
01/30/2007