Provider First Line Business Practice Location Address:
907 KANSAS AVE.
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
PHILLIPSBURG
Provider Business Practice Location Address State Name:
KS
Provider Business Practice Location Address Postal Code:
67661-2500
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
785-543-5190
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
05/04/2007