Provider Demographics
NPI:1447091996
Name:SONTERRE, MIKALYN
Entity type:Individual
Prefix:
First Name:MIKALYN
Middle Name:
Last Name:SONTERRE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1001 W 6TH ST
Mailing Address - Street 2:
Mailing Address - City:DULUTH
Mailing Address - State:MN
Mailing Address - Zip Code:55806-2305
Mailing Address - Country:US
Mailing Address - Phone:612-802-3288
Mailing Address - Fax:
Practice Address - Street 1:7400 E HAMPDEN AVE UNIT C-3
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80231-4861
Practice Address - Country:US
Practice Address - Phone:303-221-1474
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-06-06
Last Update Date:2024-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist