Provider First Line Business Practice Location Address:
2700 CLAY EDWARDS DRIVE, SUITE 240
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
NORTH KANSAS CITY
Provider Business Practice Location Address State Name:
MO
Provider Business Practice Location Address Postal Code:
64116-2539
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
816-691-2021
Provider Business Practice Location Address Fax Number:
816-346-7690
Provider Enumeration Date:
06/24/2009