Provider Demographics
NPI:1144615451
Name:ROOS, SONDRA (PT)
Entity Type:Individual
Prefix:
First Name:SONDRA
Middle Name:
Last Name:ROOS
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3650 W SAINT ALBANS PL
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85742-5151
Mailing Address - Country:US
Mailing Address - Phone:520-977-0909
Mailing Address - Fax:
Practice Address - Street 1:3650 W SAINT ALBANS PL
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85742-5151
Practice Address - Country:US
Practice Address - Phone:520-977-0909
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-04-02
Last Update Date:2015-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ6062225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist