Provider First Line Business Practice Location Address:
5911 NW BARRY ROAD
Provider Second Line Business Practice Location Address:
SUITE 100
Provider Business Practice Location Address City Name:
KANSAS CITY
Provider Business Practice Location Address State Name:
MO
Provider Business Practice Location Address Postal Code:
64154
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
816-587-4640
Provider Business Practice Location Address Fax Number:
816-587-5320
Provider Enumeration Date:
11/07/2006