Provider First Line Business Practice Location Address:
8800 BALLENTINE ROAD
Provider Second Line Business Practice Location Address:
SHRGILENTA OF JOHNSON COUNTY
Provider Business Practice Location Address City Name:
OVERLAND PARK
Provider Business Practice Location Address State Name:
KS
Provider Business Practice Location Address Postal Code:
66212
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
913-594-4050
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
01/22/2007