Provider First Line Business Practice Location Address:
932 N 50TH STREET
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
KANSAS CITY
Provider Business Practice Location Address State Name:
KS
Provider Business Practice Location Address Postal Code:
66102
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
913-287-9600
Provider Business Practice Location Address Fax Number:
913-287-5960
Provider Enumeration Date:
08/18/2006