Provider First Line Business Practice Location Address:
201 N MAIN ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
HAYSVILLE
Provider Business Practice Location Address State Name:
KS
Provider Business Practice Location Address Postal Code:
67060-1813
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
316-522-5583
Provider Business Practice Location Address Fax Number:
316-524-4197
Provider Enumeration Date:
03/20/2007