Provider First Line Business Practice Location Address:
5721 W 119TH ST
Provider Second Line Business Practice Location Address:
EMERGENCY DEPARTMENT
Provider Business Practice Location Address City Name:
OVERLAND PARK
Provider Business Practice Location Address State Name:
KS
Provider Business Practice Location Address Postal Code:
66209-3722
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
913-469-4244
Provider Business Practice Location Address Fax Number:
913-489-1939
Provider Enumeration Date:
12/01/2005