Provider First Line Business Practice Location Address:
6145 TROOST AVE
Provider Second Line Business Practice Location Address:
STE 200
Provider Business Practice Location Address City Name:
KANSAS CITY
Provider Business Practice Location Address State Name:
MO
Provider Business Practice Location Address Postal Code:
64110-3435
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
816-923-2550
Provider Business Practice Location Address Fax Number:
816-923-7134
Provider Enumeration Date:
11/15/2006