Healthcare Provider Details

I. General information

NPI: 1205437928
Provider Name (Legal Business Name): SONIA CRAFT ALLAN PT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/09/2020
Last Update Date: 11/09/2020
Certification Date: 11/09/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

979 E 3RD ST STE A245
CHATTANOOGA TN
37403-3355
US

IV. Provider business mailing address

PO BOX 24927
CHATTANOOGA TN
37422-4927
US

V. Phone/Fax

Practice location:
  • Phone: 423-778-4747
  • Fax: 423-778-4751
Mailing address:
  • Phone: 423-643-2576
  • Fax: 423-648-4570

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: