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General NPI Number Information
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NPI Number | 1649883869
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Entity Type | Individual
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Provider Name | JENA MARIE BROPHY
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Gender | Female
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Dates
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Enumeration Date | 08/27/2020
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Last Update Date | 08/27/2020
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Provider Practice Location Address
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Address Line | 2 EMANUEL CLEAVER II BLVD
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City | KANSAS CITY
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State | MO
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Zip | 64112-1654
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Country | US
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Telephone | 503-376-9469
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Fax |
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Provider Business Mailing Address
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Address Line | 3520 RAINBOW BLVD APT 722
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City | KANSAS CITY
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State | KS
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Zip | 66103-2089
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Country | US
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Telephone | 314-603-2268
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 2020027875
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License Number State | MO
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