Provider First Line Business Practice Location Address:
601 E 16TH STREET
Provider Second Line Business Practice Location Address:
BOTHWELL REGIONAL HEALTH CENTER
Provider Business Practice Location Address City Name:
SEDALIA
Provider Business Practice Location Address State Name:
MO
Provider Business Practice Location Address Postal Code:
65301
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
660-827-9410
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
02/09/2017