Provider First Line Business Practice Location Address:
5658 SW 29TH 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:
66614-2443
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
785-289-7022
Provider Business Practice Location Address Fax Number:
785-339-5871
Provider Enumeration Date:
12/16/2025