Provider First Line Business Practice Location Address:
2914 SW PLASS CT
Provider Second Line Business Practice Location Address:
SUITE B
Provider Business Practice Location Address City Name:
TOPEKA
Provider Business Practice Location Address State Name:
KS
Provider Business Practice Location Address Postal Code:
66611-1925
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
785-266-7980
Provider Business Practice Location Address Fax Number:
785-266-8035
Provider Enumeration Date:
02/06/2006