Provider Demographics
NPI:1629828652
Name:ROMBECK, JANA L (MOT, OTR/L)
Entity Type:Individual
Prefix:
First Name:JANA
Middle Name:L
Last Name:ROMBECK
Suffix:
Gender:F
Credentials:MOT, OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:245 S ONEWOOD DR
Mailing Address - Street 2:
Mailing Address - City:ANDOVER
Mailing Address - State:KS
Mailing Address - Zip Code:67002-8815
Mailing Address - Country:US
Mailing Address - Phone:785-766-1867
Mailing Address - Fax:
Practice Address - Street 1:12 S LAKEVIEW CT
Practice Address - Street 2:
Practice Address - City:GODDARD
Practice Address - State:KS
Practice Address - Zip Code:67052-9228
Practice Address - Country:US
Practice Address - Phone:316-252-0445
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-03-25
Last Update Date:2024-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS17-02218225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist