Individual
SUSIE HUMPHREYS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2600 SW WARD RD, LEES SUMMIT, MO 64082-2107
(816) 718-6518
Mailing address
2600 SW WARD RD, LEES SUMMIT, MO 64082-2107
(816) 718-6518
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
114598
MO
Other
Enumeration date
10/22/2018
Last updated
10/22/2018
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