Healthcare Provider Details

I. General information

NPI: 1104331693
Provider Name (Legal Business Name): SUNFLOWER THERAPY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/06/2017
Last Update Date: 12/06/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

500 KINDLEBERGER ROAD
KANSAS CITY KS
66115
US

IV. Provider business mailing address

P.O. BOX 2449
SHAWNEE MISSION KS
66201
US

V. Phone/Fax

Practice location:
  • Phone: 913-321-8765
  • Fax: 913-573-2022
Mailing address:
  • Phone: 913-321-8765
  • Fax: 913-573-2022

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License Number11-00002
License Number StateKS
# 2
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number11-00451
License Number StateKS

VIII. Authorized Official

Name: MR. THOMAS JOHNSON ALLEGRI
Title or Position: OWNER
Credential: RPT
Phone: 913-568-5977