Provider First Line Business Practice Location Address:
200 NE BARRY RD STE 216
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:
64155-2722
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
816-907-3131
Provider Business Practice Location Address Fax Number:
816-920-0361
Provider Enumeration Date:
10/16/2024