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General NPI Number Information
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NPI Number | 1407461759
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Entity Type | Individual
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Provider Name | KAITLIN LOUISE STUMP PT, DPT
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Gender | Female
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Dates
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Enumeration Date | 09/14/2020
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Last Update Date | 09/14/2020
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Provider Practice Location Address
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Address Line | 1108 E PATTERSON ST STE 6
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City | KIRKSVILLE
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State | MO
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Zip | 63501-4010
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Country | US
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Telephone | 660-665-5333
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Fax |
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Provider Business Mailing Address
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Address Line | 17496 BEAR DR
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City | LANCASTER
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State | MO
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Zip | 63548-4206
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Country | US
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Telephone | 660-342-5105
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number |
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License Number State |
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