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Individual

ZACHARY RYAN STAPLES

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
4100 S 4TH ST, LEAVENWORTH, KS 66048-5082
(913) 758-6188
Mailing address
624 JEFFERSON ST, MARYVILLE, MO 64468-2507
(660) 215-0879

Taxonomy

Speciality
Code
Description
License number
State
207PS0010X
Sports Medicine (Emergency Medicine) Physician
Primary
0000
KS

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0000
KS
Enumeration date
01/19/2023
Last updated
01/19/2023
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