Healthcare Provider Details

I. General information

NPI: 1235664848
Provider Name (Legal Business Name): SARAH PLOWMAN ATC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/21/2017
Last Update Date: 04/21/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2030 E COLLEGE WAY
OLATHE KS
66062-1851
US

IV. Provider business mailing address

560 N 900TH RD
LAWRENCE KS
66047-9590
US

V. Phone/Fax

Practice location:
  • Phone: 913-971-3513
  • Fax:
Mailing address:
  • Phone: 620-617-5833
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2255A2300X
TaxonomyAthletic Trainer
License Number24-00893
License Number StateKS
# 2
Primary TaxonomyN
Taxonomy Code2255A2300X
TaxonomyAthletic Trainer
License Number2015038677
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: