Provider First Line Business Practice Location Address:
3901 RAINBOW BLVD # MS -2026
Provider Second Line Business Practice Location Address:
KU MEDICAL CENTER
Provider Business Practice Location Address City Name:
KANSAS CITY
Provider Business Practice Location Address State Name:
KS
Provider Business Practice Location Address Postal Code:
66160-0001
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
913-588-6009
Provider Business Practice Location Address Fax Number:
913-588-3987
Provider Enumeration Date:
06/19/2006