Provider First Line Business Practice Location Address:
10304 NW PRAIRIE VIEW 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:
64153
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
816-281-7280
Provider Business Practice Location Address Fax Number:
816-396-9655
Provider Enumeration Date:
05/28/2026