Provider First Line Business Practice Location Address:
2029 BUCHANAN
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
NORTH KANSAS CITY
Provider Business Practice Location Address State Name:
MO
Provider Business Practice Location Address Postal Code:
64116
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
816-474-7322
Provider Business Practice Location Address Fax Number:
816-474-6202
Provider Enumeration Date:
07/06/2006