Provider First Line Business Practice Location Address:
1000 E 24TH ST STE 2E
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:
64108-2776
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
816-404-5850
Provider Business Practice Location Address Fax Number:
816-404-6049
Provider Enumeration Date:
02/04/2015