=====================================================
General NPI Number Information
=====================================================
NPI Number | 1710023353
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | MONICA JOYCE DOWNS P.T.
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 01/30/2007
-----------------------------------------------------
Last Update Date | 09/10/2009
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 750 N SOCORA ST SUITE 200
-----------------------------------------------------
City | WICHITA
-----------------------------------------------------
State | KS
-----------------------------------------------------
Zip | 67212-3793
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 316-219-8299
-----------------------------------------------------
Fax | 316-219-5899
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 9300 E 29TH ST N STE 205
-----------------------------------------------------
City | WICHITA
-----------------------------------------------------
State | KS
-----------------------------------------------------
Zip | 67226-2182
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 316-219-8299
-----------------------------------------------------
Fax | 316-219-5899
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 2251S0007X
-----------------------------------------------------
Taxonomy Name | Sports Physical Therapist
-----------------------------------------------------
License Number | 11-01657
-----------------------------------------------------
License Number State | KS
-----------------------------------------------------