Provider First Line Business Practice Location Address:
5701 STATE AVE
Provider Second Line Business Practice Location Address:
SUITE 300
Provider Business Practice Location Address City Name:
KANSAS CITY
Provider Business Practice Location Address State Name:
KS
Provider Business Practice Location Address Postal Code:
66102
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
913-279-5450
Provider Business Practice Location Address Fax Number:
913-596-2399
Provider Enumeration Date:
08/31/2006