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General NPI Number Information
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NPI Number | 1073299681
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Entity Type | Organization
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Legal Business Name | SONNYS PLACE OF WAYNESBORO
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Dates
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Enumeration Date | 06/27/2023
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Last Update Date | 06/27/2023
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Provider Practice Location Address
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Address Line | 514 S HIGH ST
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City | WAYNESBORO
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State | TN
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Zip | 38485-2615
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Country | US
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Telephone | 931-332-6858
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 261
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City | WAYNESBORO
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State | TN
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Zip | 38485-0261
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Country | US
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Telephone | 931-332-6858
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | EMMA RISNER
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Credential | OTR/L
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Telephone | 931-332-6858
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number |
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License Number State |
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