Provider First Line Business Practice Location Address:
2800 CLAY EDWARDS DR.
Provider Second Line Business Practice Location Address:
ATTN: OUTPATIENT TREATMENT CENTER
Provider Business Practice Location Address City Name:
N KANSAS CITY
Provider Business Practice Location Address State Name:
MO
Provider Business Practice Location Address Postal Code:
64116
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
816-691-5319
Provider Business Practice Location Address Fax Number:
816-346-7554
Provider Enumeration Date:
05/16/2023