Provider First Line Business Practice Location Address:
3601 SW 29TH ST
Provider Second Line Business Practice Location Address:
SUITE 134
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:
785-273-1493
Provider Business Practice Location Address Fax Number:
785-273-1195
Provider Enumeration Date:
03/22/2007