Provider First Line Business Practice Location Address:
400 SW 29TH STREET
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:
66611-1164
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
316-221-3008
Provider Business Practice Location Address Fax Number:
316-221-3015
Provider Enumeration Date:
02/20/2014