Healthcare Provider Details

I. General information

NPI: 1700331337
Provider Name (Legal Business Name): ASHTON STUBBS DPT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/24/2016
Last Update Date: 08/24/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1321 SW MARKET ST
LEES SUMMIT MO
64081-2904
US

IV. Provider business mailing address

1321 SW MARKET ST
LEES SUMMIT MO
64081-2904
US

V. Phone/Fax

Practice location:
  • Phone: 816-607-7180
  • Fax: 816-607-7181
Mailing address:
  • Phone: 816-607-7180
  • Fax: 816-607-7181

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number2016024489
License Number StateMO

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: