Provider First Line Business Practice Location Address:
8301 N CONGRESS AVE
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:
64152-2041
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
816-741-6737
Provider Business Practice Location Address Fax Number:
816-746-5850
Provider Enumeration Date:
05/22/2007