Provider First Line Business Practice Location Address:
248 NE. 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:
64155
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
816-368-8120
Provider Business Practice Location Address Fax Number:
800-687-5070
Provider Enumeration Date:
11/17/2020