Provider First Line Business Practice Location Address:
139 CAMPUS CREEK COMPLEX
Provider Second Line Business Practice Location Address:
KSU FAMILY CENTER
Provider Business Practice Location Address City Name:
MANHATTAN
Provider Business Practice Location Address State Name:
KS
Provider Business Practice Location Address Postal Code:
66506
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
785-532-6984
Provider Business Practice Location Address Fax Number:
785-532-6523
Provider Enumeration Date:
04/27/2007