Provider Demographics
NPI:1932412939
Name:VONLOSSNITZER, PETER (PT)
Entity Type:Individual
Prefix:
First Name:PETER
Middle Name:
Last Name:VONLOSSNITZER
Suffix:
Gender:M
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:PO BOX 866308
Mailing Address - Street 2:
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75086-6308
Mailing Address - Country:US
Mailing Address - Phone:800-793-5464
Mailing Address - Fax:267-321-2099
Practice Address - Street 1:721 E FALMOUTH HWY
Practice Address - Street 2:
Practice Address - City:EAST FALMOUTH
Practice Address - State:MA
Practice Address - Zip Code:02536-6191
Practice Address - Country:US
Practice Address - Phone:508-540-7609
Practice Address - Fax:508-540-7539
Is Sole Proprietor?:No
Enumeration Date:2010-07-19
Last Update Date:2010-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA9124225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist