Provider First Line Business Practice Location Address:
510 E CARTHAGE ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
MEADE
Provider Business Practice Location Address State Name:
KS
Provider Business Practice Location Address Postal Code:
67864-6401
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
620-873-2112
Provider Business Practice Location Address Fax Number:
620-873-5371
Provider Enumeration Date:
06/01/2018