Provider First Line Business Practice Location Address:
427 S OAK ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
GARNETT
Provider Business Practice Location Address State Name:
KS
Provider Business Practice Location Address Postal Code:
66032-1337
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
785-448-6650
Provider Business Practice Location Address Fax Number:
785-448-6686
Provider Enumeration Date:
08/31/2006