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General NPI Number Information
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NPI Number | 1568352292
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Entity Type | Individual
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Provider Name | SONYA L BARGE LMT
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Gender |
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Dates
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Enumeration Date | 07/04/2025
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Last Update Date | 07/04/2025
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Provider Practice Location Address
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Address Line | 129 LOCUST ST
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City | ELIZABETHVILLE
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State | PA
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Zip | 17023-8727
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Country | US
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Telephone | 717-559-0525
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Fax |
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Provider Business Mailing Address
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Address Line | 301 MAIN ST
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City | LYKENS
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State | PA
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Zip | 17048-1210
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Country | US
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Telephone | 717-571-3769
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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 | 225700000X
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Taxonomy Name | Massage Therapist
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License Number | MSG016420
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License Number State | PA
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