Provider First Line Business Practice Location Address:
1100 SW WANAMAKER RD STE 205
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:
66604-2678
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
785-347-8382
Provider Business Practice Location Address Fax Number:
785-591-2076
Provider Enumeration Date:
09/03/2026