Provider First Line Business Practice Location Address:
900 W 48TH PL STE 900
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
KANSAS CITY
Provider Business Practice Location Address State Name:
MO
Provider Business Practice Location Address Postal Code:
64112-1899
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
816-572-4615
Provider Business Practice Location Address Fax Number:
816-817-5180
Provider Enumeration Date:
07/27/2006