Provider First Line Business Practice Location Address:
4901 NE BARRY RD
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:
64156-1219
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
816-437-3656
Provider Business Practice Location Address Fax Number:
816-437-3660
Provider Enumeration Date:
03/02/2010