Individual
DR. THOMAS BERTONCINO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
A.T.C.
Contact information
Practice address
4100 S 4TH ST, LEAVENWORTH, KS 66048-5082
(913) 758-6260
Mailing address
4100 S 4TH ST, LEAVENWORTH, KS 66048-5082
(913) 758-6260
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
24-01072
KS
Other
Enumeration date
03/17/2016
Last updated
03/17/2016
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