Provider First Line Business Practice Location Address:
1200 N 7TH ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
KANSAS CITY
Provider Business Practice Location Address State Name:
KS
Provider Business Practice Location Address Postal Code:
66101-2104
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
913-951-8731
Provider Business Practice Location Address Fax Number:
913-426-9057
Provider Enumeration Date:
04/24/2023