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Individual

MR. STEVE HAROLD HEGSTROM

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
C.P.T.A.

Contact information

Practice address
10300 W 103RD ST, SUITE 300, OVERLAND PARK, KS 66214-2642
(913) 941-1910
Mailing address
5045 OUTLOOK RD, MISSION, KS 66202-1842
(913) 677-4806

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
117642
MO
174400000X
Specialist
Primary
14-00052
KS

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
117642
MISSOURI LICENSE
MO
01
14-00052
STATE LICENSE
KS
Enumeration date
02/26/2007
Last updated
07/08/2007
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