Provider First Line Business Practice Location Address:
800 W 47TH ST
Provider Second Line Business Practice Location Address:
STE. 220
Provider Business Practice Location Address City Name:
KANSAS CITY
Provider Business Practice Location Address State Name:
MO
Provider Business Practice Location Address Postal Code:
64112-1251
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
816-561-8200
Provider Business Practice Location Address Fax Number:
816-561-8201
Provider Enumeration Date:
08/17/2006