Individual
JONATHON STACKHOUSE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1525 N 7 HWY STE 201, PLEASANT HILL, MO 64080-1980
(816) 308-0246
(816) 566-0486
Mailing address
441 NW HWY W, KINGSVILLE, MO 64061
(816) 308-0246
(816) 566-0486
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
2021002313
MO
Other
Enumeration date
01/23/2023
Last updated
12/11/2023
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