Provider First Line Business Practice Location Address:
3601 SW 29TH ST
Provider Second Line Business Practice Location Address:
SUITE 217
Provider Business Practice Location Address City Name:
TOPEKA
Provider Business Practice Location Address State Name:
KS
Provider Business Practice Location Address Postal Code:
66614-2078
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
785-272-8808
Provider Business Practice Location Address Fax Number:
785-272-0814
Provider Enumeration Date:
02/24/2006