Provider First Line Business Practice Location Address:
125 WEST US HIGHWAY 36
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SAINT FRANCIS
Provider Business Practice Location Address State Name:
KS
Provider Business Practice Location Address Postal Code:
67756-0453
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
785-332-8888
Provider Business Practice Location Address Fax Number:
785-332-2617
Provider Enumeration Date:
05/31/2005