Provider First Line Business Practice Location Address:
202 S WASHINGTON ST
Provider Second Line Business Practice Location Address:
BOX 158
Provider Business Practice Location Address City Name:
MARQUETTE
Provider Business Practice Location Address State Name:
KS
Provider Business Practice Location Address Postal Code:
67464-9775
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
785-546-2211
Provider Business Practice Location Address Fax Number:
785-546-2035
Provider Enumeration Date:
01/25/2007