Provider First Line Business Practice Location Address:
3101 BROADWAY BLVD.
Provider Second Line Business Practice Location Address:
ALLERGY/IMMUNOLOGY
Provider Business Practice Location Address City Name:
KANSAS CITY
Provider Business Practice Location Address State Name:
MO
Provider Business Practice Location Address Postal Code:
64111
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
816-960-8885
Provider Business Practice Location Address Fax Number:
816-960-8888
Provider Enumeration Date:
06/11/2013