Individual
KEEGAN MCCLOUD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1507 NE 77TH ST, KANSAS CITY, MO 64118-1924
(913) 710-3949
Mailing address
1507 NE 77TH ST, KANSAS CITY, MO 64118-1924
(913) 710-3949
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
—
—
225200000X
Physical Therapy Assistant
14-03000
KS
225200000X
Physical Therapy Assistant
Primary
2016005668
MO
Other
Enumeration date
03/23/2016
Last updated
07/28/2022
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