Provider First Line Business Practice Location Address:
127 E 46TH ST
Provider Second Line Business Practice Location Address:
#7
Provider Business Practice Location Address City Name:
KANSAS CITY
Provider Business Practice Location Address State Name:
MO
Provider Business Practice Location Address Postal Code:
64112-1730
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
816-588-4777
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
07/17/2009