Healthcare Provider Details

I. General information

NPI: 1942495072
Provider Name (Legal Business Name): SONIA NADINE DUNCOMBE PT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/11/2007
Last Update Date: 09/11/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15100 METCALF AVE SUITE 102
OVERLAND PARK KS
66223-2899
US

IV. Provider business mailing address

3110 E 55TH ST
KANSAS CITY MO
64130-4029
US

V. Phone/Fax

Practice location:
  • Phone: 913-897-1100
  • Fax:
Mailing address:
  • Phone: 816-444-6384
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2251S0007X
TaxonomySports Physical Therapist
License Number3709
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: