Provider First Line Business Practice Location Address:
2300 METROPOLITAN AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
KANSAS CITY
Provider Business Practice Location Address State Name:
KS
Provider Business Practice Location Address Postal Code:
66106-2900
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
913-748-0502
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
08/19/2022