Provider First Line Business Practice Location Address:
140 A EAST 9TH STREET
Provider Second Line Business Practice Location Address:
140 A
Provider Business Practice Location Address City Name:
AUBURN
Provider Business Practice Location Address State Name:
KS
Provider Business Practice Location Address Postal Code:
66402-0147
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
785-256-2489
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
10/07/2015