Provider First Line Business Practice Location Address:
608 N KENNEDY ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SHARON SPRINGS
Provider Business Practice Location Address State Name:
KS
Provider Business Practice Location Address Postal Code:
67758-9701
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
785-230-0244
Provider Business Practice Location Address Fax Number:
785-414-5055
Provider Enumeration Date:
05/22/2023