Provider First Line Business Practice Location Address:
1575 N. UNIVERSAL AVE
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:
64120
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
816-245-5700
Provider Business Practice Location Address Fax Number:
816-245-5702
Provider Enumeration Date:
07/03/2006