Provider Demographics
NPI:1942066295
Name:SONNEBERGER, KARISSA (DPT)
Entity Type:Individual
Prefix:
First Name:KARISSA
Middle Name:
Last Name:SONNEBERGER
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:701 NORTH ST
Mailing Address - Street 2:
Mailing Address - City:AUBURN
Mailing Address - State:IN
Mailing Address - Zip Code:46706-1633
Mailing Address - Country:US
Mailing Address - Phone:260-333-0031
Mailing Address - Fax:260-333-0685
Practice Address - Street 1:701 NORTH ST
Practice Address - Street 2:
Practice Address - City:AUBURN
Practice Address - State:IN
Practice Address - Zip Code:46706-1633
Practice Address - Country:US
Practice Address - Phone:260-333-0031
Practice Address - Fax:260-333-0685
Is Sole Proprietor?:No
Enumeration Date:2024-02-26
Last Update Date:2024-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist