Provider First Line Business Practice Location Address:
1711 N 4TH ST
Provider Second Line Business Practice Location Address:
ARKANSAS CITY
Provider Business Practice Location Address City Name:
ARKANSAS CITY
Provider Business Practice Location Address State Name:
KS
Provider Business Practice Location Address Postal Code:
67005-1607
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
316-461-0496
Provider Business Practice Location Address Fax Number:
620-442-4089
Provider Enumeration Date:
08/05/2008