Provider First Line Business Practice Location Address:
1512 E IRON AVE
Provider Second Line Business Practice Location Address:
SUITE B
Provider Business Practice Location Address City Name:
SALINA
Provider Business Practice Location Address State Name:
KS
Provider Business Practice Location Address Postal Code:
67401-3236
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
785-493-8400
Provider Business Practice Location Address Fax Number:
785-493-8401
Provider Enumeration Date:
08/23/2005