Provider First Line Business Practice Location Address:
604 WASHINGTON ST.
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
CONCORDIA
Provider Business Practice Location Address State Name:
KS
Provider Business Practice Location Address Postal Code:
66901
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
785-508-1324
Provider Business Practice Location Address Fax Number:
785-414-5375
Provider Enumeration Date:
09/04/2013