Provider First Line Business Practice Location Address:
155 SOUTH 18TH STREET
Provider Second Line Business Practice Location Address:
SUITE 220
Provider Business Practice Location Address City Name:
KANSAS CITY
Provider Business Practice Location Address State Name:
KS
Provider Business Practice Location Address Postal Code:
66102
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
913-321-7327
Provider Business Practice Location Address Fax Number:
913-321-3168
Provider Enumeration Date:
07/31/2006