Provider Demographics
NPI:1669592283
Name:JOCKISCH-DAVIS, SONJA (CRT)
Entity type:Individual
Prefix:
First Name:SONJA
Middle Name:
Last Name:JOCKISCH-DAVIS
Suffix:
Gender:F
Credentials:CRT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1207 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:GREENSBORO
Mailing Address - State:AL
Mailing Address - Zip Code:36744-1502
Mailing Address - Country:US
Mailing Address - Phone:334-624-0511
Mailing Address - Fax:
Practice Address - Street 1:1207 MAIN ST
Practice Address - Street 2:
Practice Address - City:GREENSBORO
Practice Address - State:AL
Practice Address - Zip Code:36744-1502
Practice Address - Country:US
Practice Address - Phone:334-624-0511
Practice Address - Fax:334-624-0509
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-29
Last Update Date:2009-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1558227800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes227800000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRespiratory Therapist, Certified