Provider First Line Business Practice Location Address:
1901 E FIRST STREET
Provider Second Line Business Practice Location Address:
PRAIPRIE VIEW INC
Provider Business Practice Location Address City Name:
NEWTON
Provider Business Practice Location Address State Name:
KS
Provider Business Practice Location Address Postal Code:
67114-2449
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
316-284-6400
Provider Business Practice Location Address Fax Number:
316-284-6352
Provider Enumeration Date:
05/02/2008