MEDICARE: SANDRA ANN DO PT

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
1	225100000X	Physical Therapist	3217	CO

General Provider Information

NPI Number	:	1780637397
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SANDRA ANN DO PT

Provider Business Mailing Address
First Line	:	12001 W 63RD PL
Second Line	:
City	:	ARVADA
State	:	CO
Zip	:	80004-4034
Country	:	US
Telephone Number	:	303-456-2671
Fax Number	:	303-456-0220

Provider Business Practice Location Address
First Line	:	12001 W 63RD PL
Second Line	:
City	:	ARVADA
State	:	CO
Zip	:	80004-4034
Country	:	US
Telephone Number	:	303-456-2671
Fax Number	:	303-456-0220

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/18/2006
Last Update Date	:	12/18/2007

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Directions to “ SANDRA ANN DO PT” Practice Location

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