Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2251G0304X | Physical Therapist - Geriatrics | 1018 | SD |
NPI | 1407049836 |
---|---|
Provider Name | Angela Rae Sonnenschein |
First Address | Harrisburg, SD 57032-8109 |
Second Address | Harrisburg, SD 57032-8109 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 20/08/2007 |
Last Update Date | 20/08/2007 |