Provider First Line Business Practice Location Address:
1170 SW MISSION AVE SUITE B
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
TOPEKA
Provider Business Practice Location Address State Name:
KS
Provider Business Practice Location Address Postal Code:
66604
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
785-506-3600
Provider Business Practice Location Address Fax Number:
785-783-5265
Provider Enumeration Date:
12/01/2006