Provider First Line Business Practice Location Address:
2129 SW WANAMAKER RD
Provider Second Line Business Practice Location Address:
SUITE B
Provider Business Practice Location Address City Name:
TOPEKA
Provider Business Practice Location Address State Name:
KS
Provider Business Practice Location Address Postal Code:
66614-5213
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
785-272-6737
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
10/03/2006