Provider First Line Business Practice Location Address:
304 E 3RD ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
WASHINGTON
Provider Business Practice Location Address State Name:
KS
Provider Business Practice Location Address Postal Code:
66968-2033
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
785-325-2211
Provider Business Practice Location Address Fax Number:
785-325-3224
Provider Enumeration Date:
06/01/2015