Provider First Line Business Practice Location Address:
423 HOUSTON ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
MANHATTAN
Provider Business Practice Location Address State Name:
KS
Provider Business Practice Location Address Postal Code:
66502
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
785-587-4344
Provider Business Practice Location Address Fax Number:
785-587-4377
Provider Enumeration Date:
06/25/2013