Provider First Line Business Practice Location Address:
2144 SW 36TH ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
TOPEKA
Provider Business Practice Location Address State Name:
KS
Provider Business Practice Location Address Postal Code:
66611-2554
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
785-266-1010
Provider Business Practice Location Address Fax Number:
785-266-5312
Provider Enumeration Date:
09/28/2006