Provider First Line Business Practice Location Address:
501 WASHINGTON ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
CONCORDIA
Provider Business Practice Location Address State Name:
KS
Provider Business Practice Location Address Postal Code:
66901-2116
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
785-243-7927
Provider Business Practice Location Address Fax Number:
785-243-1208
Provider Enumeration Date:
08/10/2005