MemberID
670405
LIC
NULL
HIN
NULL
Address
615 S High St
City
Caney
STATE
KS
AssignmentStatus
NULL
Account
NULL
Client
NULL
Affiliate
Territory
NULL
Website
NULL
RegionalSponsor
NULL
XetexCode
PR670405
SystemID
670403
ParentID
605082
CompanyCode
Premier, Inc
ClassOfTrade
Phone
(620) 879-2929
Fax
(620) 879-2930