Provider Demographics
NPI:1013416312
Name:BYARS, SONJA
Entity Type:Individual
Prefix:
First Name:SONJA
Middle Name:
Last Name:BYARS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3146 OZMER LNDG
Mailing Address - Street 2:
Mailing Address - City:DECATUR
Mailing Address - State:GA
Mailing Address - Zip Code:30034-4788
Mailing Address - Country:US
Mailing Address - Phone:404-259-7731
Mailing Address - Fax:
Practice Address - Street 1:3146 OZMER LNDG
Practice Address - Street 2:
Practice Address - City:DECATUR
Practice Address - State:GA
Practice Address - Zip Code:30034-4788
Practice Address - Country:US
Practice Address - Phone:404-259-7731
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-02-02
Last Update Date:2018-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA000472225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant