Provider First Line Business Practice Location Address:
6400 PROSPECT AVE
Provider Second Line Business Practice Location Address:
SUITE 228
Provider Business Practice Location Address City Name:
KANSAS CITY
Provider Business Practice Location Address State Name:
MO
Provider Business Practice Location Address Postal Code:
64132-1100
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
816-444-5525
Provider Business Practice Location Address Fax Number:
816-444-1947
Provider Enumeration Date:
05/18/2006