Provider First Line Business Practice Location Address:
3120 SW 29TH ST
Provider Second Line Business Practice Location Address:
SUITE A
Provider Business Practice Location Address City Name:
TOPEKA
Provider Business Practice Location Address State Name:
KS
Provider Business Practice Location Address Postal Code:
66614-2007
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
785-272-2460
Provider Business Practice Location Address Fax Number:
785-273-6596
Provider Enumeration Date:
12/28/2006