Provider First Line Business Practice Location Address:
1902 S HWY 59 BLDG A
Provider Second Line Business Practice Location Address:
STE 2
Provider Business Practice Location Address City Name:
PARSONS
Provider Business Practice Location Address State Name:
KS
Provider Business Practice Location Address Postal Code:
67357-4948
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
620-421-6210
Provider Business Practice Location Address Fax Number:
620-421-9394
Provider Enumeration Date:
12/23/2011