Individual
MISS JESSICA DIVINEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
24527 119TH ST, KANSAS CITY, KS 66109-6803
(913) 683-2404
Mailing address
24527 119TH ST, KANSAS CITY, KS 66109-6803
(913) 683-2404
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
—
—
Other
Enumeration date
05/11/2012
Last updated
05/11/2012
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