Provider First Line Business Practice Location Address:
5325 FARAON STREET
Provider Second Line Business Practice Location Address:
PATHOLOGY
Provider Business Practice Location Address City Name:
ST. JOSEPH
Provider Business Practice Location Address State Name:
MO
Provider Business Practice Location Address Postal Code:
64506
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
816-271-1376
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
01/10/2006