Provider First Line Business Practice Location Address:
1325 E 1ST ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
MCPHERSON
Provider Business Practice Location Address State Name:
KS
Provider Business Practice Location Address Postal Code:
67460-3601
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
620-241-0266
Provider Business Practice Location Address Fax Number:
620-241-6061
Provider Enumeration Date:
02/22/2006