Individual
MRS. STACI MCKINNON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
8812 NE 101ST ST, KANSAS CITY, MO 64157-7887
(816) 273-2084
Mailing address
8812 NE 101ST ST, KANSAS CITY, MO 64157-7887
(816) 273-2084
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
117405
MO
Other
Enumeration date
12/22/2014
Last updated
01/08/2015
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