Healthcare Provider Details

I. General information

NPI: 1851201990
Provider Name (Legal Business Name): LONGGAME PT LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/10/2026
Last Update Date: 09/10/2026
Certification Date: 09/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13154 STATE LINE RD STE C
LEAWOOD KS
66209-1708
US

IV. Provider business mailing address

5238 REEDS RD
MISSION KS
66202-1854
US

V. Phone/Fax

Practice location:
  • Phone: 913-229-4398
  • Fax:
Mailing address:
  • Phone: 913-229-4398
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2251S0007X
TaxonomySports Physical Therapist
License Number
License Number State

VIII. Authorized Official

Name: JOSHUA DARBY
Title or Position: OWNER/PHYSICAL THERAPIST
Credential: MSPT, FAFS, CMTPT/DN
Phone: 913-229-4398