Provider Demographics
NPI:1619117108
Name:SOMMER, JULIANE (LMT)
Entity Type:Individual
Prefix:
First Name:JULIANE
Middle Name:
Last Name:SOMMER
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2175 K STREET NW C-120
Mailing Address - Street 2:SPORTS AND SPINAL PHYSICAL THERAPY
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20037-1878
Mailing Address - Country:US
Mailing Address - Phone:202-463-7611
Mailing Address - Fax:202-463-7611
Practice Address - Street 1:2175 K STREET NW C-120
Practice Address - Street 2:SPORTS AND SPINAL PHYSICAL THERAPY
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20037-1878
Practice Address - Country:US
Practice Address - Phone:202-463-7611
Practice Address - Fax:202-463-7611
Is Sole Proprietor?:Yes
Enumeration Date:2009-02-24
Last Update Date:2010-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCMT290174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
DCG00519Medicare PIN