Healthcare Provider Details

I. General information

NPI: 1548154222
Provider Name (Legal Business Name): GARYN DUANE STEWART DC
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/05/2025
Last Update Date: 09/04/2025
Certification Date: 09/04/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1332 NW WINDSOR DRIVE SUITE 3
LEE'S SUMMIT MO
64086
US

IV. Provider business mailing address

8681 W 108TH PL
OVERLAND PARK KS
66210-1604
US

V. Phone/Fax

Practice location:
  • Phone: 417-766-3406
  • Fax:
Mailing address:
  • Phone: 417-766-3406
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number2025018480
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: