Provider First Line Business Practice Location Address:
4601 STATE AVE UNIT 38
Provider Second Line Business Practice Location Address:
EDUCATION CENTER
Provider Business Practice Location Address City Name:
KANSAS CITY
Provider Business Practice Location Address State Name:
KS
Provider Business Practice Location Address Postal Code:
66102-3608
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
913-627-5676
Provider Business Practice Location Address Fax Number:
913-627-5688
Provider Enumeration Date:
12/15/2006