Provider First Line Business Practice Location Address: 
1000 HOSPITAL DR
    Provider Second Line Business Practice Location Address: 
    Provider Business Practice Location Address City Name: 
MCPHERSON
    Provider Business Practice Location Address State Name: 
KS
    Provider Business Practice Location Address Postal Code: 
67460-2326
    Provider Business Practice Location Address Country Code: 
US
    Provider Business Practice Location Address Telephone Number: 
620-241-2251
    Provider Business Practice Location Address Fax Number: 
    Provider Enumeration Date: 
08/07/2020