Provider First Line Business Practice Location Address:
1805 NW PLATTE RD STE 110
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:
64150-7500
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
816-691-5200
Provider Business Practice Location Address Fax Number:
816-346-7148
Provider Enumeration Date:
05/31/2018