Provider First Line Business Practice Location Address:
1111 S.W. 8TH
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
PLAINVILLE
Provider Business Practice Location Address State Name:
KS
Provider Business Practice Location Address Postal Code:
67663
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
785-434-2530
Provider Business Practice Location Address Fax Number:
785-434-2552
Provider Enumeration Date:
02/15/2008