Doctor Name: | COURTNEY SPONGBERG |
NPI Number: | 1285083162 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | PT, DPT, ATC |
License Number: | 1105340 |
Business Practice Address: | 550 Pope Ave Fort Leavenworth, KS - 660272332 |
Business Phone Number: | 9136846650 |
Business Fax Number: | |
Mailing Address: | 333 W 46th Ter Apt 302, KANSAS CITY |
State: | MO |
Postal Code: | 641121500 |
Phone Number: | 4024100085 |
Fax Number: | |
NPI Enumeration Date: | 06/10/2016 |
NPI Last Update Date: | 06/13/2016 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 225100000X |
License Number: | 1105340 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | KS |
Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
Taxonomy Classification: | Physical Therapist |
Taxonomy Specialization: | |
Taxonomy Definition: | (1) Physical therapists are health care professionals who evaluate and treat people with health problems resulting from injury or disease. PT |