Provider First Line Business Practice Location Address:
505 N FRANKLIN AVE STE B
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:
67701-2342
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
785-462-3348
Provider Business Practice Location Address Fax Number:
785-462-3599
Provider Enumeration Date:
08/22/2006