Provider First Line Business Practice Location Address:
103 N WASHINGTON ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
PLAINVILLE
Provider Business Practice Location Address State Name:
KS
Provider Business Practice Location Address Postal Code:
67663-2010
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
785-543-2700
Provider Business Practice Location Address Fax Number:
785-540-4041
Provider Enumeration Date:
04/21/2014