Individual
GRANT P KIRSCHBAUM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PTA
Contact information
Practice address
111 NE MOCK AVE, BLUE SPRINGS, MO 64014-2503
(816) 729-8038
Mailing address
1041 SW REDBUCK CIR, LEES SUMMIT, MO 64081-3867
(816) 729-8038
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
2023032658
MO
Other
Enumeration date
08/24/2023
Last updated
08/24/2023
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