Provider First Line Business Practice Location Address:
516 SE 29TH ST
Provider Second Line Business Practice Location Address:
SUITE UPPER
Provider Business Practice Location Address City Name:
TOPEKA
Provider Business Practice Location Address State Name:
KS
Provider Business Practice Location Address Postal Code:
66605-1190
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
785-246-6426
Provider Business Practice Location Address Fax Number:
785-246-6581
Provider Enumeration Date:
12/17/2013