Provider First Line Business Practice Location Address:
1902 S HIGHWAY 59
Provider Second Line Business Practice Location Address:
BLDG D
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:
620-421-0881
Provider Business Practice Location Address Fax Number:
620-421-8391
Provider Enumeration Date:
06/22/2005