Provider First Line Business Practice Location Address:
624 SW 24TH ST
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:
66611-1294
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
785-235-7600
Provider Business Practice Location Address Fax Number:
785-575-6112
Provider Enumeration Date:
09/20/2006