Provider First Line Business Practice Location Address:
1500 SW 10TH AVE
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:
66604-1301
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
785-354-4740
Provider Business Practice Location Address Fax Number:
785-233-2295
Provider Enumeration Date:
09/26/2006