Provider First Line Business Practice Location Address:
207 N 7TH ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
HUMBOLDT
Provider Business Practice Location Address State Name:
KS
Provider Business Practice Location Address Postal Code:
66748-1447
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
620-405-0771
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
03/01/2023