Provider First Line Business Practice Location Address:
19600 E 39TH ST
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:
64108-2640
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
816-698-7000
Provider Business Practice Location Address Fax Number:
913-428-2951
Provider Enumeration Date:
07/05/2023