Provider Demographics
NPI:1295089803
Name:SOMMERS, JANIS (LMT, CT)
Entity type:Individual
Prefix:MS
First Name:JANIS
Middle Name:
Last Name:SOMMERS
Suffix:
Gender:F
Credentials:LMT, CT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:677 W MAIN ST
Mailing Address - Street 2:
Mailing Address - City:HYANNIS
Mailing Address - State:MA
Mailing Address - Zip Code:02601-3493
Mailing Address - Country:US
Mailing Address - Phone:774-722-9717
Mailing Address - Fax:
Practice Address - Street 1:677 WEST MAIN STREET
Practice Address - Street 2:
Practice Address - City:HARWICH
Practice Address - State:MA
Practice Address - Zip Code:02601
Practice Address - Country:US
Practice Address - Phone:774-722-9717
Practice Address - Fax:508-790-0808
Is Sole Proprietor?:Yes
Enumeration Date:2012-11-05
Last Update Date:2012-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MAMA5310172M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172M00000XOther Service ProvidersMechanotherapist