Provider First Line Business Practice Location Address:
8530 N GREEN HILLS ROAD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
KANSAS CITY
Provider Business Practice Location Address State Name:
MO
Provider Business Practice Location Address Postal Code:
64154
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
816-587-5555
Provider Business Practice Location Address Fax Number:
816-587-0552
Provider Enumeration Date:
12/12/2006