Provider Demographics
NPI:1134571391
Name:STAHLY, ALEC (ATC)
Entity type:Individual
Prefix:
First Name:ALEC
Middle Name:
Last Name:STAHLY
Suffix:
Gender:M
Credentials:ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7575 W 106TH ST APT 332
Mailing Address - Street 2:
Mailing Address - City:OVERLAND PARK
Mailing Address - State:KS
Mailing Address - Zip Code:66212-5965
Mailing Address - Country:US
Mailing Address - Phone:316-217-2859
Mailing Address - Fax:
Practice Address - Street 1:1 ARROWHEAD DR
Practice Address - Street 2:
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64129-1651
Practice Address - Country:US
Practice Address - Phone:816-920-9300
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-07-12
Last Update Date:2016-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer