Provider First Line Business Practice Location Address:
2715 SW 29TH ST
Provider Second Line Business Practice Location Address:
SUITE C
Provider Business Practice Location Address City Name:
TOPEKA
Provider Business Practice Location Address State Name:
KS
Provider Business Practice Location Address Postal Code:
66614-2044
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
785-272-0122
Provider Business Practice Location Address Fax Number:
785-272-1097
Provider Enumeration Date:
02/06/2006