Provider First Line Business Practice Location Address:
1516 SW 6TH AVE
Provider Second Line Business Practice Location Address:
SUITE 1
Provider Business Practice Location Address City Name:
TOPEKA
Provider Business Practice Location Address State Name:
KS
Provider Business Practice Location Address Postal Code:
66606-1696
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
785-232-1005
Provider Business Practice Location Address Fax Number:
785-232-2564
Provider Enumeration Date:
09/06/2012