Provider First Line Business Practice Location Address:
6 S METCALF RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
LOUISBURG
Provider Business Practice Location Address State Name:
KS
Provider Business Practice Location Address Postal Code:
66053-4116
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
913-837-5555
Provider Business Practice Location Address Fax Number:
913-837-5569
Provider Enumeration Date:
03/26/2012