Provider First Line Business Practice Location Address:
620 W 8TH STREET
Provider Second Line Business Practice Location Address:
C/O EDWARDS COUNTY HOSPITAL
Provider Business Practice Location Address City Name:
KINSLEY
Provider Business Practice Location Address State Name:
KS
Provider Business Practice Location Address Postal Code:
67547-2329
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
620-659-3625
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
11/07/2006