Provider Demographics
NPI:1477039618
Name:SAPP SONTAG, KARA LYN (ATC)
Entity Type:Individual
Prefix:MRS
First Name:KARA
Middle Name:LYN
Last Name:SAPP SONTAG
Suffix:
Gender:F
Credentials:ATC
Other - Prefix:MISS
Other - First Name:KARA
Other - Middle Name:LYN
Other - Last Name:SAPP
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:BS, ATC
Mailing Address - Street 1:2050 AUSTELL RD SW APT N5
Mailing Address - Street 2:
Mailing Address - City:MARIETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30008-4161
Mailing Address - Country:US
Mailing Address - Phone:856-279-8210
Mailing Address - Fax:
Practice Address - Street 1:1269 BARCLAY CIR SE
Practice Address - Street 2:
Practice Address - City:MARIETTA
Practice Address - State:GA
Practice Address - Zip Code:30060-2903
Practice Address - Country:US
Practice Address - Phone:856-279-8210
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-07-11
Last Update Date:2018-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA2255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer