Provider First Line Business Practice Location Address:
19600 E 39TH ST S
Provider Second Line Business Practice Location Address:
EMERGENCY ROOM
Provider Business Practice Location Address City Name:
INDEPENDENCE
Provider Business Practice Location Address State Name:
MO
Provider Business Practice Location Address Postal Code:
64057-2301
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
816-698-7170
Provider Business Practice Location Address Fax Number:
816-698-7194
Provider Enumeration Date:
05/15/2007