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NPI Code Detail

MEDICARE: NICOLE CHRISTINE SANDRUCK

MEDICARE: NICOLE CHRISTINE SANDRUCK
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225100000XPhysical Therapist29443MD

General Provider Information

NPI Number : 1083309504
Entity Type Code : Individual
Provider Name (Legal Business Name) : NICOLE CHRISTINE SANDRUCK
Provider Business Mailing Address
First Line : 8200 EVERGREEN DR
Second Line :
City : BALTIMORE
State : MD
Zip : 21234-5509
Country : US
Telephone Number : 443-529-6434
Fax Number :
Provider Business Practice Location Address
First Line : 7629 BELAIR RD
Second Line :
City : NOTTINGHAM
State : MD
Zip : 21236-4003
Country : US
Telephone Number : 410-870-2104
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/10/2023
Last Update Date : 07/06/2023

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Directions to “ NICOLE CHRISTINE SANDRUCK ” Practice Location

Language Start Address Practice Location
These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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