Provider First Line Business Practice Location Address:
429 ALABAMA ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
LAWRENCE
Provider Business Practice Location Address State Name:
KS
Provider Business Practice Location Address Postal Code:
66044
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
785-550-1983
Provider Business Practice Location Address Fax Number:
785-783-5328
Provider Enumeration Date:
01/29/2008