Individual
JUDY KY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PAC
Contact information
Practice address
3265 NE RALPH POWELL RD, LEES SUMMIT, MO 64064-2301
(913) 451-7546
(816) 875-1894
Mailing address
3265 NE RALPH POWELL RD, LEES SUMMIT, MO 64064-2301
(913) 451-7546
(816) 875-1894
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
1500978
KS
363A00000X
Physician Assistant
Primary
2014009311
MO
Other
Enumeration date
09/21/2006
Last updated
08/04/2017
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