Provider First Line Business Practice Location Address:
807 S WASHINGTON ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
WEIR
Provider Business Practice Location Address State Name:
KS
Provider Business Practice Location Address Postal Code:
66781-4230
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
620-231-2162
Provider Business Practice Location Address Fax Number:
620-231-2162
Provider Enumeration Date:
06/15/2007