Provider First Line Business Practice Location Address:
1217 S 15TH ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
PARSONS
Provider Business Practice Location Address State Name:
KS
Provider Business Practice Location Address Postal Code:
67357-5125
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
620-421-2431
Provider Business Practice Location Address Fax Number:
620-423-0158
Provider Enumeration Date:
11/08/2010