Provider First Line Business Practice Location Address:
3625 SW 29TH ST
Provider Second Line Business Practice Location Address:
SUITE 202
Provider Business Practice Location Address City Name:
TOPEKA
Provider Business Practice Location Address State Name:
KS
Provider Business Practice Location Address Postal Code:
66614-2061
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
785-273-7189
Provider Business Practice Location Address Fax Number:
785-273-3816
Provider Enumeration Date:
04/16/2008