Provider First Line Business Practice Location Address:
6401 EAST FRONT STREET
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:
64120-1356
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
816-241-0603
Provider Business Practice Location Address Fax Number:
816-241-6276
Provider Enumeration Date:
12/11/2007