Provider First Line Business Practice Location Address:
1535 SOUTH RANGE AVE.
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
COLBY
Provider Business Practice Location Address State Name:
KS
Provider Business Practice Location Address Postal Code:
67701-0806
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
785-460-8000
Provider Business Practice Location Address Fax Number:
785-460-8001
Provider Enumeration Date:
03/10/2006