Provider First Line Business Practice Location Address:
409 LINCOLN AVE
Provider Second Line Business Practice Location Address:
ERICKSON MEDICAL CLINIC LLC
Provider Business Practice Location Address City Name:
CLAY CENTER
Provider Business Practice Location Address State Name:
KS
Provider Business Practice Location Address Postal Code:
67432-2907
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
785-777-2622
Provider Business Practice Location Address Fax Number:
785-777-2623
Provider Enumeration Date:
02/25/2016