Provider First Line Business Practice Location Address: 
7900 LEES SUMMIT RD
    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: 
64139-1236
    Provider Business Practice Location Address Country Code: 
US
    Provider Business Practice Location Address Telephone Number: 
816-404-7000
    Provider Business Practice Location Address Fax Number: 
816-404-7110
    Provider Enumeration Date: 
03/22/2011