Provider First Line Business Practice Location Address:
316 MAIN ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SENECA
Provider Business Practice Location Address State Name:
KS
Provider Business Practice Location Address Postal Code:
66538-1924
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
785-336-2181
Provider Business Practice Location Address Fax Number:
785-336-2182
Provider Enumeration Date:
07/20/2006