Provider First Line Business Practice Location Address:
1420 S 42ND ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
KANSAS CITY
Provider Business Practice Location Address State Name:
KS
Provider Business Practice Location Address Postal Code:
66106-1952
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
913-831-1100
Provider Business Practice Location Address Fax Number:
913-831-0827
Provider Enumeration Date:
02/23/2006