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General NPI Number Information
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NPI Number | 1104141332
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Entity Type | Individual
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Provider Name | DANIEL SONNTAG LMT, CAT
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Gender | Male
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Dates
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Enumeration Date | 03/31/2010
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Last Update Date | 03/31/2010
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Provider Practice Location Address
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Address Line | 119-29 80TH ROAD #A
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City | KEW GARDENS
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State | NY
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Zip | 11415
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Country | US
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Telephone | 718-607-5062
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Fax |
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Provider Business Mailing Address
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Address Line | 8339 116TH ST APT 6A
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City | RICHMOND HILL
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State | NY
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Zip | 11418
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Country | US
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Telephone | 718-607-5062
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Fax | 509-356-3993
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225700000X
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Taxonomy Name | Massage Therapist
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License Number |
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License Number State |
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