Provider First Line Business Practice Location Address:
7735 WASHINGTON AVE
Provider Second Line Business Practice Location Address:
SUITE C
Provider Business Practice Location Address City Name:
KANSAS CITY
Provider Business Practice Location Address State Name:
KS
Provider Business Practice Location Address Postal Code:
66112-2444
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
816-746-6556
Provider Business Practice Location Address Fax Number:
816-746-6353
Provider Enumeration Date:
01/02/2014