Provider First Line Business Practice Location Address:
155 S 18TH ST
Provider Second Line Business Practice Location Address:
STE 260
Provider Business Practice Location Address City Name:
KANSAS CITY
Provider Business Practice Location Address State Name:
KS
Provider Business Practice Location Address Postal Code:
66102-5654
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
913-299-7100
Provider Business Practice Location Address Fax Number:
913-299-7102
Provider Enumeration Date:
06/27/2005