Provider First Line Business Practice Location Address:
4321 WASHINGTON ST
Provider Second Line Business Practice Location Address:
STE 6000
Provider Business Practice Location Address City Name:
KANSAS CITY
Provider Business Practice Location Address State Name:
MO
Provider Business Practice Location Address Postal Code:
64111-5933
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
816-753-6511
Provider Business Practice Location Address Fax Number:
816-227-4099
Provider Enumeration Date:
06/28/2005