Provider Demographics
NPI:1104157429
Name:BRITT, SONDRA (PTA)
Entity type:Individual
Prefix:
First Name:SONDRA
Middle Name:
Last Name:BRITT
Suffix:
Gender:F
Credentials:PTA
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 1591
Mailing Address - Street 2:
Mailing Address - City:LAURINBURG
Mailing Address - State:NC
Mailing Address - Zip Code:28353-1591
Mailing Address - Country:US
Mailing Address - Phone:910-276-3940
Mailing Address - Fax:
Practice Address - Street 1:100 GOSSMAN RD
Practice Address - Street 2:
Practice Address - City:SOUTHERN PINES
Practice Address - State:NC
Practice Address - Zip Code:28387-2281
Practice Address - Country:US
Practice Address - Phone:910-246-1148
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-01-26
Last Update Date:2010-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCA4245225200000X
SC2383225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant