Provider First Line Business Practice Location Address:
5810 NW BARRY RD
Provider Second Line Business Practice Location Address:
STE 100
Provider Business Practice Location Address City Name:
KANSAS CITY
Provider Business Practice Location Address State Name:
MO
Provider Business Practice Location Address Postal Code:
64154-1493
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
816-584-8100
Provider Business Practice Location Address Fax Number:
816-584-8106
Provider Enumeration Date:
12/28/2005