Provider First Line Business Practice Location Address:
1801 N 98TH STREET
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:
66109
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
913-717-4750
Provider Business Practice Location Address Fax Number:
816-302-9939
Provider Enumeration Date:
02/14/2007