Provider First Line Business Practice Location Address:
4227 N. OAK TRFY
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:
64116-4541
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
816-453-1050
Provider Business Practice Location Address Fax Number:
816-453-3102
Provider Enumeration Date:
12/29/2005