Provider First Line Business Practice Location Address:
2945 SW WANAMAKER DR
Provider Second Line Business Practice Location Address:
SUITE D
Provider Business Practice Location Address City Name:
TOPEKA
Provider Business Practice Location Address State Name:
KS
Provider Business Practice Location Address Postal Code:
66614-5321
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
785-271-9697
Provider Business Practice Location Address Fax Number:
785-228-0775
Provider Enumeration Date:
05/27/2006