Healthcare Provider Details

I. General information

NPI: 1841582723
Provider Name (Legal Business Name): SARAH LEONARD
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/10/2011
Last Update Date: 05/10/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5209 OUTLOOK ST
MISSION KS
66202-1846
US

IV. Provider business mailing address

5209 OUTLOOK ST
MISSION KS
66202-1846
US

V. Phone/Fax

Practice location:
  • Phone: 913-449-6514
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code283X00000X
TaxonomyRehabilitation Hospital
License Number
License Number State

VIII. Authorized Official

Name: SARAH LEONARD
Title or Position: PTA
Credential:
Phone: 913-449-6514