Provider First Line Business Practice Location Address:
2101 CHARLOTTE ST
Provider Second Line Business Practice Location Address:
UNIVERSITY HEALTH
Provider Business Practice Location Address City Name:
KANSAS CITY
Provider Business Practice Location Address State Name:
MO
Provider Business Practice Location Address Postal Code:
64108-2727
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
816-404-4356
Provider Business Practice Location Address Fax Number:
816-404-4359
Provider Enumeration Date:
06/20/2016