Provider First Line Business Practice Location Address:
5563 NW 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:
64154-1408
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
816-841-2600
Provider Business Practice Location Address Fax Number:
816-841-2601
Provider Enumeration Date:
09/08/2010