Individual
COURTNEY SPONGBERG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PT, DPT, ATC
Contact information
Practice address
550 POPE AVE, FORT LEAVENWORTH, KS 66027-2332
(913) 684-6650
Mailing address
333 W 46TH TER APT 302, KANSAS CITY, MO 64112-1500
(402) 410-0085
Taxonomy
Speciality
Code
Description
License number
State
204C00000X
Sports Medicine (Neuromusculoskeletal Medicine) Physician
1105340
KS
225100000X
Physical Therapist
Primary
1105340
KS
Other
Enumeration date
06/10/2016
Last updated
12/07/2023
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