Provider First Line Business Practice Location Address:
4119 NW BARRY RD
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:
64154-1100
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
816-452-4488
Provider Business Practice Location Address Fax Number:
816-705-3660
Provider Enumeration Date:
03/15/2022