Healthcare Provider Details

I. General information

NPI: 1881598571
Provider Name (Legal Business Name): SOPHIE MARIE LEBEGERN PT, DPT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/06/2026
Last Update Date: 10/09/2026
Certification Date: 10/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3929 PEACHTREE RD NE STE 100
BROOKHAVEN GA
30319-3374
US

IV. Provider business mailing address

3333 CONTESSA CT
ANNANDALE VA
22003-1119
US

V. Phone/Fax

Practice location:
  • Phone: 770-740-1860
  • Fax: 470-299-5025
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number2305217794
License Number StateVA
# 2
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberCP059443T
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: