Provider First Line Business Practice Location Address:
4011 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:
66614-2218
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
785-272-2161
Provider Business Practice Location Address Fax Number:
785-272-1970
Provider Enumeration Date:
02/23/2006