Provider First Line Business Practice Location Address:
3615 SW 29TH ST
Provider Second Line Business Practice Location Address:
STE 201
Provider Business Practice Location Address City Name:
TOPEKA
Provider Business Practice Location Address State Name:
KS
Provider Business Practice Location Address Postal Code:
66614-2077
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
785-228-9443
Provider Business Practice Location Address Fax Number:
785-228-9640
Provider Enumeration Date:
02/22/2007