| Organization Name: | STARZ PEDIATRIC THERAPY NETWORK |
| NPI Number: | 1518261320 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | STACEE NEWSOM (PHYSICAL THERAPIST, OWNER) |
| Mailing Address: | 640 Nw Jefferson St Grain Valley |
| State: | MO US |
| Postal Code: | 640298278 |
| Phone Number: | 8167267337 |
| Fax Number: | 8168470218 |
| NPI Enumeration Date: | 01/07/2011 |
| NPI Last Update Date: | 08/28/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QR0400X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Rehabilitation |
| Taxonomy Definition: | |