Provider First Line Business Practice Location Address:
2401 GILLHAM ROAD
Provider Second Line Business Practice Location Address:
CHILDREN'S MERCY HOSPITAL AND CLINICS- NEUROLOGY DEPT
Provider Business Practice Location Address City Name:
KANSAS CITY
Provider Business Practice Location Address State Name:
MO
Provider Business Practice Location Address Postal Code:
64108-4698
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
816-234-3090
Provider Business Practice Location Address Fax Number:
816-234-3589
Provider Enumeration Date:
06/11/2007