Provider First Line Business Practice Location Address:
2534 CAMPBELL ST STE B
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
KANSAS CITY
Provider Business Practice Location Address State Name:
MO
Provider Business Practice Location Address Postal Code:
64108-2730
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
816-283-3877
Provider Business Practice Location Address Fax Number:
816-283-3310
Provider Enumeration Date:
12/07/2022