Provider First Line Business Practice Location Address:
817A ARGYLE AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
MINNEAPOLIS
Provider Business Practice Location Address State Name:
KS
Provider Business Practice Location Address Postal Code:
67467-1621
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
785-392-2822
Provider Business Practice Location Address Fax Number:
785-392-3640
Provider Enumeration Date:
07/29/2006