Provider First Line Business Practice Location Address:
3901 RAINBOW BLVD, 6040 DELP, MS 1020
Provider Second Line Business Practice Location Address:
DIVISION OF GENERAL AND GERIATRIC MEDICINE, UNIVERSITY
Provider Business Practice Location Address City Name:
KANSAS CITY
Provider Business Practice Location Address State Name:
KS
Provider Business Practice Location Address Postal Code:
66160-0001
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
913-588-6005
Provider Business Practice Location Address Fax Number:
913-588-3877
Provider Enumeration Date:
01/11/2012