Provider First Line Business Practice Location Address:
302 E 2ND ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
WASHINGTON
Provider Business Practice Location Address State Name:
KS
Provider Business Practice Location Address Postal Code:
66968-2029
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
785-325-2240
Provider Business Practice Location Address Fax Number:
785-325-2277
Provider Enumeration Date:
07/11/2014