Provider First Line Business Practice Location Address:
9200 NE BARRY RD STE 110
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:
64157-1209
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
816-607-1775
Provider Business Practice Location Address Fax Number:
816-379-3748
Provider Enumeration Date:
04/08/2024