Provider First Line Business Practice Location Address:
8605 NW PRAIRIE VIEW RD # 225
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:
64153-1846
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
816-741-7220
Provider Business Practice Location Address Fax Number:
816-741-7228
Provider Enumeration Date:
01/17/2007