Provider Demographics
NPI:1508013152
Name:SPONENBURG, SARAH C (PT)
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:C
Last Name:SPONENBURG
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 1:4901 N SHORE DR
Mailing Address - Street 2:
Mailing Address - City:NORTH LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72118-5293
Mailing Address - Country:US
Mailing Address - Phone:501-791-3331
Mailing Address - Fax:501-791-0294
Practice Address - Street 1:4901 N SHORE DR
Practice Address - Street 2:
Practice Address - City:NORTH LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72118-5293
Practice Address - Country:US
Practice Address - Phone:501-791-3331
Practice Address - Fax:501-791-0294
Is Sole Proprietor?:Yes
Enumeration Date:2008-08-26
Last Update Date:2008-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR2982225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist