Provider First Line Business Practice Location Address:
940 S. ST. FRANCIS
Provider Second Line Business Practice Location Address:
GUADALUPE CLINIC
Provider Business Practice Location Address City Name:
WICHITA
Provider Business Practice Location Address State Name:
KS
Provider Business Practice Location Address Postal Code:
67211
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
316-264-8974
Provider Business Practice Location Address Fax Number:
316-262-4938
Provider Enumeration Date:
10/24/2013