Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2251N0400X | Physical Therapist - Neurology | 2003004584 | MO |
NPI | 1689815466 |
---|---|
Provider Name | Stacy R Kinstler |
First Address | Saint Louis, MO 63128-3737 |
Second Address | Saint Louis, MO 63125-4181 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/03/2009 |
Last Update Date | 09/03/2009 |