Provider First Line Business Practice Location Address:
9520 JAMES A REED RD
Provider Second Line Business Practice Location Address:
SUITE C
Provider Business Practice Location Address City Name:
KANSAS CITY
Provider Business Practice Location Address State Name:
MO
Provider Business Practice Location Address Postal Code:
64134-1689
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
816-763-8005
Provider Business Practice Location Address Fax Number:
816-966-1459
Provider Enumeration Date:
04/09/2010