Provider First Line Business Practice Location Address:
3950 NEWMAN RD
Provider Second Line Business Practice Location Address:
KUHN HALL 306 HEALTH SERVICES OFFICE
Provider Business Practice Location Address City Name:
JOPLIN
Provider Business Practice Location Address State Name:
MO
Provider Business Practice Location Address Postal Code:
64801-1512
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
417-625-9323
Provider Business Practice Location Address Fax Number:
417-659-4376
Provider Enumeration Date:
10/29/2008