Provider Demographics
NPI:1376862979
Name:COMBS, MAGEN (PT, DPT, OTR/L, MOT)
Entity Type:Individual
Prefix:
First Name:MAGEN
Middle Name:
Last Name:COMBS
Suffix:
Gender:F
Credentials:PT, DPT, OTR/L, MOT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:108 C ST
Mailing Address - Street 2:
Mailing Address - City:GOLDEN CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64748-8210
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:200 N 16TH ST
Practice Address - Street 2:
Practice Address - City:PARSONS
Practice Address - State:KS
Practice Address - Zip Code:67357-3227
Practice Address - Country:US
Practice Address - Phone:620-820-4293
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-05-20
Last Update Date:2021-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2009017803225100000X
MO2009021241225X00000X
KS17-03641225X00000X
KS11-06322225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
No225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist