Provider First Line Business Practice Location Address:
1915 SW 6TH AVE
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:
66606-1601
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
785-295-8240
Provider Business Practice Location Address Fax Number:
785-295-5490
Provider Enumeration Date:
06/17/2005