Provider First Line Business Practice Location Address: 
1700 SW 7TH STREET
    Provider Second Line Business Practice Location Address: 
2ND FLOOR
    Provider Business Practice Location Address City Name: 
TOPEKA
    Provider Business Practice Location Address State Name: 
KS
    Provider Business Practice Location Address Postal Code: 
66606-1690
    Provider Business Practice Location Address Country Code: 
US
    Provider Business Practice Location Address Telephone Number: 
785-295-7800
    Provider Business Practice Location Address Fax Number: 
785-231-5990
    Provider Enumeration Date: 
07/15/2011