Provider First Line Business Practice Location Address:
423 N. E. 69 HIGHWAY
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:
64119-3118
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
816-455-2224
Provider Business Practice Location Address Fax Number:
816-454-7511
Provider Enumeration Date:
01/24/2007