Individual
STACEY ANN MATHIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1000 CARONDELET DR, KANSAS CITY, MO 64114-4673
(816) 943-4545
(816) 943-4526
Mailing address
10701 NALL AVE STE 130, OVERLAND PARK, KS 66211-1231
(913) 663-2555
(913) 663-3766
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
1401949
KS
225200000X
Physical Therapy Assistant
Primary
2008008651
MO
Other
Enumeration date
07/29/2008
Last updated
11/05/2010
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