Provider First Line Business Practice Location Address:
5549 HIGHWAY K OLD HIGHWAY 13
Provider Second Line Business Practice Location Address:
GOOD SAMARITAN BOYS RANCH
Provider Business Practice Location Address City Name:
BRIGHTON
Provider Business Practice Location Address State Name:
MO
Provider Business Practice Location Address Postal Code:
65617
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
417-376-2238
Provider Business Practice Location Address Fax Number:
417-376-2014
Provider Enumeration Date:
08/12/2013