Provider Demographics
NPI:1326472705
Name:KINESPHERE PHYSICAL THERAPY LLC
Entity Type:Organization
Organization Name:KINESPHERE PHYSICAL THERAPY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICAL THERAPIST/PRINCIPAL
Authorized Official - Prefix:DR
Authorized Official - First Name:NOELLE
Authorized Official - Middle Name:SUSAN
Authorized Official - Last Name:DOWMA
Authorized Official - Suffix:
Authorized Official - Credentials:DPT
Authorized Official - Phone:816-379-6899
Mailing Address - Street 1:10880 BENSON DR STE 2370
Mailing Address - Street 2:
Mailing Address - City:OVERLAND PARK
Mailing Address - State:KS
Mailing Address - Zip Code:66210-1599
Mailing Address - Country:US
Mailing Address - Phone:816-379-6899
Mailing Address - Fax:816-817-0034
Practice Address - Street 1:10880 BENSON DR STE 2370
Practice Address - Street 2:
Practice Address - City:OVERLAND PARK
Practice Address - State:KS
Practice Address - Zip Code:66210
Practice Address - Country:US
Practice Address - Phone:816-379-6899
Practice Address - Fax:816-817-0034
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-08-21
Last Update Date:2018-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS11-035902251X0800X
MO20060083192251X0800X
261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedicGroup - Multi-Specialty
No261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical TherapyGroup - Multi-Specialty