Provider First Line Business Practice Location Address:
2700 CLAY EDWARDS DR.
Provider Second Line Business Practice Location Address:
SUITE 400 MERITAS HEALTH NKC
Provider Business Practice Location Address City Name:
NORTH KANSAS CITY
Provider Business Practice Location Address State Name:
MO
Provider Business Practice Location Address Postal Code:
64116
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
816-421-4240
Provider Business Practice Location Address Fax Number:
816-221-5439
Provider Enumeration Date:
04/03/2010