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Individual

STACY HEINEN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PT

Contact information

Practice address
1900 W 75TH ST, SUITE 10, PRAIRIE VILLAGE, KS 66208-3502
(913) 432-3950
(913) 432-3948
Mailing address
1900 W 75TH ST, SUITE 10, PRAIRIE VILLAGE, KS 66208-3502
(913) 432-3950
(913) 432-3948

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
11-03748
KS
225100000X
Physical Therapist
2004018044
MO

Other

Enumeration date
01/23/2017
Last updated
01/23/2017
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