Provider First Line Business Practice Location Address:
21 N 12TH ST
Provider Second Line Business Practice Location Address:
SUITE 400
Provider Business Practice Location Address City Name:
KANSAS CITY
Provider Business Practice Location Address State Name:
KS
Provider Business Practice Location Address Postal Code:
66102-5161
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
816-922-7600
Provider Business Practice Location Address Fax Number:
816-448-2904
Provider Enumeration Date:
01/04/2006