Provider First Line Business Practice Location Address:
304 W 7TH ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
WELLSVILLE
Provider Business Practice Location Address State Name:
KS
Provider Business Practice Location Address Postal Code:
66092-7800
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
785-883-4101
Provider Business Practice Location Address Fax Number:
785-883-2200
Provider Enumeration Date:
07/09/2006