Provider First Line Business Practice Location Address:
PO BOX 70
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
OSBORNE
Provider Business Practice Location Address State Name:
KS
Provider Business Practice Location Address Postal Code:
67473-0070
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
785-346-2510
Provider Business Practice Location Address Fax Number:
785-345-4163
Provider Enumeration Date:
06/23/2005