Provider First Line Business Practice Location Address:
201 NW R D MIZE RD
Provider Second Line Business Practice Location Address:
ANESTHESIA SERVICES OF BLUE SPRINGS/ST. MARY'S MEDICAL
Provider Business Practice Location Address City Name:
BLUE SPRINGS
Provider Business Practice Location Address State Name:
MO
Provider Business Practice Location Address Postal Code:
64014-2513
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
816-988-8415
Provider Business Practice Location Address Fax Number:
816-335-4003
Provider Enumeration Date:
09/26/2006