Provider First Line Business Practice Location Address:
1200 W RADIO LN
Provider Second Line Business Practice Location Address:
ATHLETIC TRAINING ROOM
Provider Business Practice Location Address City Name:
ARKANSAS CITY
Provider Business Practice Location Address State Name:
KS
Provider Business Practice Location Address Postal Code:
67005-4001
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
620-441-2010
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
05/31/2006