Provider Demographics
NPI:1003484981
Name:GOMAN, DONYA MARIE (RPT)
Entity Type:Individual
Prefix:
First Name:DONYA
Middle Name:MARIE
Last Name:GOMAN
Suffix:
Gender:F
Credentials:RPT
Other - Prefix:
Other - First Name:DONYA
Other - Middle Name:MARIE
Other - Last Name:BRIAN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:RPT
Mailing Address - Street 1:7819 CONSER PL
Mailing Address - Street 2:
Mailing Address - City:OVERLAND PARK
Mailing Address - State:KS
Mailing Address - Zip Code:66204-2820
Mailing Address - Country:US
Mailing Address - Phone:913-789-9900
Mailing Address - Fax:
Practice Address - Street 1:7819 CONSER PL
Practice Address - Street 2:
Practice Address - City:OVERLAND PARK
Practice Address - State:KS
Practice Address - Zip Code:66204-2820
Practice Address - Country:US
Practice Address - Phone:913-789-9900
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-06-16
Last Update Date:2021-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS11-04274225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist