Provider First Line Business Practice Location Address:
5844 NW BARRY RD STE 120
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:
64154-1483
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
816-472-9595
Provider Business Practice Location Address Fax Number:
816-472-1132
Provider Enumeration Date:
04/11/2013