Healthcare Provider Details

I. General information

NPI: 1609335124
Provider Name (Legal Business Name): SNEHA KUMARI PT, MPT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/14/2019
Last Update Date: 02/05/2020
Certification Date: 02/05/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6640 JOHNSON DR
MISSION KS
66202-2617
US

IV. Provider business mailing address

6397 LEE HWY STE 300
CHATTANOOGA TN
37421-4915
US

V. Phone/Fax

Practice location:
  • Phone: 913-384-5810
  • Fax: 913-384-0719
Mailing address:
  • Phone: 423-238-7217
  • Fax: 423-238-3473

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number2018044733
License Number StateMO
# 2
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number11-05836
License Number StateKS

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: