Individual
STACEE NEWSOM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
P.T.
Contact information
Practice address
640 NW JEFFERSON ST, GRAIN VALLEY, MO 64029-8278
(816) 726-7337
(816) 847-0218
Mailing address
1302 NW PERSIMMON DR, GRAIN VALLEY, MO 64029-8628
(816) 726-7337
(816) 847-0218
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
2002021172
MO
Other
Enumeration date
09/27/2007
Last updated
05/23/2012
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