Provider First Line Business Practice Location Address:
815 N 6TH ST
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:
66101-2804
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
913-573-5550
Provider Business Practice Location Address Fax Number:
913-281-3655
Provider Enumeration Date:
01/03/2006