Provider First Line Business Practice Location Address:
717 E. 2ND STREET
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SMITH CENTER
Provider Business Practice Location Address State Name:
KS
Provider Business Practice Location Address Postal Code:
66967
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
785-282-6818
Provider Business Practice Location Address Fax Number:
785-282-6819
Provider Enumeration Date:
06/06/2011