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General NPI Number Information
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NPI Number | 1396247185
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Entity Type | Organization
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Legal Business Name | SONSHINE THERAPY SERVICES
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Dates
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Enumeration Date | 03/07/2018
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Last Update Date | 03/07/2018
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Provider Practice Location Address
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Address Line | 3014 EDMOND ST
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City | SAINT JOSEPH
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State | MO
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Zip | 64501-3312
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Country | US
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Telephone | 816-663-9887
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Fax |
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Provider Business Mailing Address
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Address Line | 3014 EDMOND ST
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City | SAINT JOSEPH
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State | MO
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Zip | 64501-3312
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Country | US
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Telephone | 816-663-9887
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Fax |
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Authorized Official
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Title or Position | OCCUPATIONAL THERAPIST/OWNER
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Name | LIBBY JORDAN
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Credential | OTR/L
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Telephone | 816-663-9887
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | 005493
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License Number State | MO
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