Provider First Line Business Practice Location Address:
1310 ADAMS STREET
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
KANSAS CITY
Provider Business Practice Location Address State Name:
KS
Provider Business Practice Location Address Postal Code:
66103-1359
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
913-747-2400
Provider Business Practice Location Address Fax Number:
913-397-7243
Provider Enumeration Date:
06/24/2005