Provider First Line Business Practice Location Address:
127 E MARKET ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
WARRENSBURG
Provider Business Practice Location Address State Name:
MO
Provider Business Practice Location Address Postal Code:
64093-1817
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
660-429-2822
Provider Business Practice Location Address Fax Number:
660-429-0589
Provider Enumeration Date:
03/21/2007