Provider Demographics
NPI:1629224977
Name:PUMPHREY, JUNE L (PTA)
Entity Type:Individual
Prefix:
First Name:JUNE
Middle Name:L
Last Name:PUMPHREY
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1875 190 RD
Mailing Address - Street 2:
Mailing Address - City:MANKATO
Mailing Address - State:KS
Mailing Address - Zip Code:66956-2348
Mailing Address - Country:US
Mailing Address - Phone:785-378-3209
Mailing Address - Fax:
Practice Address - Street 1:520 E 10TH ST
Practice Address - Street 2:
Practice Address - City:SUPERIOR
Practice Address - State:NE
Practice Address - Zip Code:68978-1225
Practice Address - Country:US
Practice Address - Phone:402-879-3281
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-08-18
Last Update Date:2008-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE332225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant