Provider First Line Business Practice Location Address:
4330 WORNALL RD
Provider Second Line Business Practice Location Address:
ST. LUKE'S MULTI-SPECIALTY CLINIC, MEDICAL PLAZA BLDG.
Provider Business Practice Location Address City Name:
KANSAS CITY
Provider Business Practice Location Address State Name:
MO
Provider Business Practice Location Address Postal Code:
64111-3217
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
816-932-9095
Provider Business Practice Location Address Fax Number:
816-932-3143
Provider Enumeration Date:
09/14/2005