Provider First Line Business Practice Location Address:
1300 CHERRY ST
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:
64106-2828
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
785-820-1927
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
07/08/2005