Provider First Line Business Practice Location Address:
1428 S 32ND ST
Provider Second Line Business Practice Location Address:
STE. 100
Provider Business Practice Location Address City Name:
KANSAS CITY
Provider Business Practice Location Address State Name:
KS
Provider Business Practice Location Address Postal Code:
66106-2106
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
913-831-1111
Provider Business Practice Location Address Fax Number:
913-831-0623
Provider Enumeration Date:
06/12/2008