Healthcare Provider Details

I. General information

NPI: 1659224913
Provider Name (Legal Business Name): STEPHEN PREYER LMT
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/17/2026
Last Update Date: 02/17/2026
Certification Date: 02/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

751 E 63RD ST STE 120G
KANSAS CITY MO
64110-3358
US

IV. Provider business mailing address

4419 E 105TH ST STE 120-G
KANSAS CITY MO
64137-1566
US

V. Phone/Fax

Practice location:
  • Phone: 816-517-5631
  • Fax:
Mailing address:
  • Phone: 518-961-2826
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number2019026709
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: