Individual
STEPHANIE PROVANCE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DPT
Contact information
Practice address
2401 GILLHAM RD, KANSAS CITY, MO 64108-4619
(816) 234-3380
Mailing address
2401 GILLHAM RD, KANSAS CITY, MO 64108-4619
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
2009021598
MO
Other
Enumeration date
07/30/2009
Last updated
07/30/2009
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