Provider First Line Business Practice Location Address:
8421 NW PRAIRIE VIEW RD
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:
64153-1842
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
816-746-1933
Provider Business Practice Location Address Fax Number:
816-741-8535
Provider Enumeration Date:
12/01/2020