Healthcare Provider Details

I. General information

NPI: 1720814692
Provider Name (Legal Business Name): STEMULIS ORTHOBIOLOGICS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/09/2024
Last Update Date: 09/09/2024
Certification Date: 09/09/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11340 NALL AVE STE 200A
OVERLAND PARK KS
66211-2485
US

IV. Provider business mailing address

11340 NALL AVE STE 200A
OVERLAND PARK KS
66211-2485
US

V. Phone/Fax

Practice location:
  • Phone: 816-994-9300
  • Fax: 816-994-9303
Mailing address:
  • Phone: 816-994-9300
  • Fax: 816-994-9303

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207QS0010X
TaxonomySports Medicine (Family Medicine) Physician
License Number
License Number State

VIII. Authorized Official

Name: JOSEPH WHETSTONE
Title or Position: CHIEF OPERATING OFFICER
Credential:
Phone: 816-994-9300