Provider First Line Business Practice Location Address:
599 ARMOUR ROAD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
N. KANSAS CITY
Provider Business Practice Location Address State Name:
MO
Provider Business Practice Location Address Postal Code:
64116
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
816-421-0750
Provider Business Practice Location Address Fax Number:
816-421-0802
Provider Enumeration Date:
09/15/2008