Provider First Line Business Practice Location Address:
2601 IOWA STREET
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
LAWRENCE
Provider Business Practice Location Address State Name:
KS
Provider Business Practice Location Address Postal Code:
66046
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
785-856-0909
Provider Business Practice Location Address Fax Number:
785-371-4025
Provider Enumeration Date:
05/20/2006