Provider First Line Business Practice Location Address:
11661 GRANADA ST
Provider Second Line Business Practice Location Address:
GENESIS REHAB SERVICES
Provider Business Practice Location Address City Name:
LEAWOOD
Provider Business Practice Location Address State Name:
KS
Provider Business Practice Location Address Postal Code:
66211-1473
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
913-703-7641
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
02/15/2012