Individual
SAMANTHA MARIE KOONS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3651 COLLEGE BLVD STE 100A, LEAWOOD, KS 66211-1910
(620) 877-0091
Mailing address
2900 WILLIAMSBURG TER APT K301, PLATTE CITY, MO 64079-7694
(620) 877-0091
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
2019036219
MO
2255A2300X
Athletic Trainer
Primary
24-01177
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2019036219
ATHLETIC TRAINER
MO
01
—
24-01177
ATHLETIC TRAINER
KS
Enumeration date
04/22/2020
Last updated
04/22/2020
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