Provider First Line Business Practice Location Address:
5851 NE BARNES AVE
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:
64119-3821
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
816-453-4210
Provider Business Practice Location Address Fax Number:
816-453-4210
Provider Enumeration Date:
03/26/2007