# STARZ PEDIATRIC THERAPY NETWORK

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1518261320
- **Authorized official:** STACEE NEWSOM PT (PHYSICAL THERAPIST, OWNER)
- **Authorized official phone:** (816) 726-7337

## Contact information

- **Practice address:** 640 NW JEFFERSON ST, GRAIN VALLEY, MO 64029-8278
- **Practice address phone:** (816) 726-7337
- **Practice address fax:** (816) 847-0218
- **Mailing address:** 1302 NW PERSIMMON DR, GRAIN VALLEY, MO 64029-8628
- **Mailing address phone:** (816) 726-7337
- **Mailing address fax:** (816) 847-0218

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QH0100X | Health Service Clinic/Center | — | NULL | — |
| 261QH0700X | Hearing and Speech Clinic/Center | — | NULL | — |
| 261QP2000X | Physical Therapy Clinic/Center | — | NULL | Yes |
| 261QR0400X | Rehabilitation Clinic/Center | — | NULL | — |

## Other

- **Enumeration date:** 01/07/2011
- **Last updated:** 08/28/2012