Provider First Line Business Practice Location Address:
1000 E 68TH ST STE 431
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:
64131-1304
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
816-523-5634
Provider Business Practice Location Address Fax Number:
913-371-3080
Provider Enumeration Date:
08/05/2006