Provider First Line Business Practice Location Address:
1906 MAIN ST STE B
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
PARSONS
Provider Business Practice Location Address State Name:
KS
Provider Business Practice Location Address Postal Code:
67357-3392
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
620-687-0122
Provider Business Practice Location Address Fax Number:
785-232-2833
Provider Enumeration Date:
08/11/2026