Provider First Line Business Practice Location Address:
11500 NW AMBASSADOR DRIVE
Provider Second Line Business Practice Location Address:
1ST FLOOR
Provider Business Practice Location Address City Name:
KANSAS CITY
Provider Business Practice Location Address State Name:
MO
Provider Business Practice Location Address Postal Code:
64153
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
816-891-8019
Provider Business Practice Location Address Fax Number:
816-880-7200
Provider Enumeration Date:
09/19/2008