Healthcare Provider Details

I. General information

NPI: 1295288470
Provider Name (Legal Business Name): SHAWN STENE
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/25/2016
Last Update Date: 07/25/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3215 MAIN ST SUITE 202
KANSAS CITY MO
64111-2645
US

IV. Provider business mailing address

218 DELAWARE ST APT. 308
KANSAS CITY MO
64105-1259
US

V. Phone/Fax

Practice location:
  • Phone: 816-472-1800
  • Fax:
Mailing address:
  • Phone: 913-961-7170
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number2016023763
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: