Provider First Line Business Practice Location Address:
2416 SWOPE PKWY
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:
64130-2639
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
816-921-3164
Provider Business Practice Location Address Fax Number:
816-861-1270
Provider Enumeration Date:
03/16/2016