Provider First Line Business Practice Location Address:
1230 SW HARVEY ST
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:
66604-4069
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
785-783-8559
Provider Business Practice Location Address Fax Number:
785-783-8562
Provider Enumeration Date:
01/06/2008