Provider First Line Business Practice Location Address:
505 N MAIN ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
ULYSSES
Provider Business Practice Location Address State Name:
KS
Provider Business Practice Location Address Postal Code:
67880-2135
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
620-356-1261
Provider Business Practice Location Address Fax Number:
620-356-3846
Provider Enumeration Date:
12/29/2022