Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225200000X | Physical Therapy Assistant | 2019027405 | MO |
NPI | 1013501253 |
---|---|
Provider Name | Ashley Simpson |
First Address | Kansas City, MO 64114-4670 |
Second Address | Kansas City, MO 64114-4670 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 28/02/2021 |
Last Update Date | 28/02/2021 |