Provider First Line Business Practice Location Address:
3224 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:
66614-2009
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
785-272-2601
Provider Business Practice Location Address Fax Number:
785-272-8834
Provider Enumeration Date:
12/29/2005