Provider First Line Business Practice Location Address:
406 NW 4TH ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
PLAINVILLE
Provider Business Practice Location Address State Name:
KS
Provider Business Practice Location Address Postal Code:
67663-1707
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
785-434-6399
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
11/03/2016