Provider First Line Business Practice Location Address:
500 NE BARRY 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:
64155-2879
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
816-468-7666
Provider Business Practice Location Address Fax Number:
816-436-0403
Provider Enumeration Date:
07/22/2009