Provider First Line Business Practice Location Address:
1125 NORTH 5TH STREET
Provider Second Line Business Practice Location Address:
OBOT ROOM #100
Provider Business Practice Location Address City Name:
KANSAS CITY
Provider Business Practice Location Address State Name:
KS
Provider Business Practice Location Address Postal Code:
66101-2305
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
913-348-0888
Provider Business Practice Location Address Fax Number:
913-342-2644
Provider Enumeration Date:
01/18/2023