Provider First Line Business Practice Location Address:
813 SW 8TH ST
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:
67663-3224
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
785-737-3710
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
07/10/2009