Provider First Line Business Practice Location Address:
5844 NW BARRY RD
Provider Second Line Business Practice Location Address:
STE. 110
Provider Business Practice Location Address City Name:
KANSAS CITY
Provider Business Practice Location Address State Name:
MO
Provider Business Practice Location Address Postal Code:
64154-1465
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
816-880-6100
Provider Business Practice Location Address Fax Number:
816-746-1226
Provider Enumeration Date:
11/15/2006