Provider First Line Business Practice Location Address:
600 MEDICAL CENTER DR
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
NEWTON
Provider Business Practice Location Address State Name:
KS
Provider Business Practice Location Address Postal Code:
67114-8780
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
316-804-6062
Provider Business Practice Location Address Fax Number:
316-804-6264
Provider Enumeration Date:
12/26/2006