Provider First Line Business Practice Location Address:
12121 BLUE RIDGE EXT
Provider Second Line Business Practice Location Address:
BLUE RIDGE FAMILY PHYSICIANS, STE. M
Provider Business Practice Location Address City Name:
GRANDVIEW
Provider Business Practice Location Address State Name:
MO
Provider Business Practice Location Address Postal Code:
64030-6401
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
816-761-0884
Provider Business Practice Location Address Fax Number:
816-716-1790
Provider Enumeration Date:
05/28/2006