Provider First Line Business Practice Location Address:
400 CARE CENTER DR
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
WARRENSBURG
Provider Business Practice Location Address State Name:
MO
Provider Business Practice Location Address Postal Code:
64093-3100
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
660-747-2216
Provider Business Practice Location Address Fax Number:
660-747-0807
Provider Enumeration Date:
09/13/2006