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General NPI Number Information
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NPI Number | 1730981010
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Entity Type | Individual
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Provider Name | DEANTAY HIGHTOWER
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Gender | Male
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Dates
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Enumeration Date | 03/26/2025
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Last Update Date | 03/26/2025
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Provider Practice Location Address
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Address Line | 18604 E 9TH TER N
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City | INDEPENDENCE
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State | MO
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Zip | 64056-7008
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Country | US
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Telephone | 816-799-3065
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Fax |
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Provider Business Mailing Address
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Address Line | 18604 E 9TH TER N
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City | INDEPENDENCE
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State | MO
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Zip | 64056-7008
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Country | US
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Telephone |
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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 | 251K00000X
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Taxonomy Name | Public Health or Welfare Agency
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License Number |
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License Number State |
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