Provider First Line Business Practice Location Address:
10800 N CONGRESS AVE
Provider Second Line Business Practice Location Address:
STE A
Provider Business Practice Location Address City Name:
KANSAS CITY
Provider Business Practice Location Address State Name:
MO
Provider Business Practice Location Address Postal Code:
64153-1228
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
816-801-7400
Provider Business Practice Location Address Fax Number:
816-801-7300
Provider Enumeration Date:
12/21/2006