Provider First Line Business Practice Location Address:
1408 SW TOPEKA BLVD
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:
66612-1819
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
785-234-0521
Provider Business Practice Location Address Fax Number:
785-234-2405
Provider Enumeration Date:
09/28/2006