Provider First Line Business Practice Location Address:
244 E US HIGHWAY 69
Provider Second Line Business Practice Location Address:
#202
Provider Business Practice Location Address City Name:
KANSAS CITY
Provider Business Practice Location Address State Name:
MO
Provider Business Practice Location Address Postal Code:
64119-3115
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
816-453-1198
Provider Business Practice Location Address Fax Number:
816-479-2933
Provider Enumeration Date:
08/13/2006