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Individual

STEPHANIE ELAINE BOLLENBACH

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
4320 WORNALL RD STE 530, KANSAS CITY, MO 64111-5942
(816) 932-2836
(816) 932-9868
Mailing address
901 E 104TH ST, KANSAS CITY, MO 64131-4517
(816) 599-9499

Taxonomy

Speciality
Code
Description
License number
State
208600000X
Surgery Physician
04-43151
KS
208600000X
Surgery Physician
Primary
2020020222
MO

Other

Enumeration date
04/29/2015
Last updated
08/05/2020
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