Provider First Line Business Practice Location Address:
2940 BALTIMORE
Provider Second Line Business Practice Location Address:
TRINITY, COED,
Provider Business Practice Location Address City Name:
KANSAS CITY
Provider Business Practice Location Address State Name:
MO
Provider Business Practice Location Address Postal Code:
64108
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
816-931-6500
Provider Business Practice Location Address Fax Number:
816-554-4370
Provider Enumeration Date:
10/13/2006