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General NPI Number Information
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NPI Number | 1255637013
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Entity Type | Individual
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Provider Name | ROBERT JOSEPH SONNENBERG PT, ATC
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Gender | Male
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Dates
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Enumeration Date | 01/26/2011
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Last Update Date | 06/12/2015
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Provider Practice Location Address
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Address Line | 2777 JEFFERSON DAVIS HWY
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City | STAFFORD
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State | VA
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Zip | 22554-8323
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Country | US
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Telephone | 540-412-8998
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Fax |
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Provider Business Mailing Address
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Address Line | 19328 DIMONA DR
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City | BROOKEVILLE
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State | MD
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Zip | 20833-2627
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Country | US
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Telephone | 301-219-3941
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Fax |
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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 | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 23419
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License Number State | MD
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Taxonomy #2
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 2305209356
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License Number State | VA
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