Provider First Line Business Practice Location Address:
1212 E MAIN ST
Provider Second Line Business Practice Location Address:
OSAGE COUNTY R-2 SCHOOLS
Provider Business Practice Location Address City Name:
LINN
Provider Business Practice Location Address State Name:
MO
Provider Business Practice Location Address Postal Code:
65051
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
573-897-4226
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
06/06/2007