Provider First Line Business Practice Location Address:
5 NW BARRY RD STE A
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:
64155-2728
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
816-436-5949
Provider Business Practice Location Address Fax Number:
816-436-8949
Provider Enumeration Date:
03/15/2023