Individual
MACKENZIE NICOLE KIESLICH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
8250 N CHURCH RD STE B, KANSAS CITY, MO 64158-1103
(816) 792-0524
Mailing address
9504 N CHARLOTTE CT, KANSAS CITY, MO 64155-3124
(816) 694-9901
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
2020034312
MO
Other
Enumeration date
04/26/2022
Last updated
04/26/2022
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