Provider First Line Business Practice Location Address:
5535 OSAGE AVE
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:
66106-1330
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
913-683-5577
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
08/11/2026