Provider First Line Business Practice Location Address:
4801 LINWOOD BLVD
Provider Second Line Business Practice Location Address:
VA MEDICAL CENTER
Provider Business Practice Location Address City Name:
KANSAS CITY
Provider Business Practice Location Address State Name:
MO
Provider Business Practice Location Address Postal Code:
64128
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
816-632-5312
Provider Business Practice Location Address Fax Number:
816-632-1962
Provider Enumeration Date:
06/30/2008