Provider First Line Business Practice Location Address:
10217 NORTH OAK TRAFFIC WAY
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:
64155-1715
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
816-476-4017
Provider Business Practice Location Address Fax Number:
816-476-4021
Provider Enumeration Date:
10/03/2006