MEDICARE: MRS. HOLLY JEAN SANDERS 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	PT016308	PA

General Provider Information

NPI Number	:	1851304711
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. HOLLY JEAN SANDERS PT

Provider Business Mailing Address
First Line	:	4181 LANDISVILLE RD
Second Line	:
City	:	DOYLESTOWN
State	:	PA
Zip	:	18901-1131
Country	:	US
Telephone Number	:	215-348-3489
Fax Number	:

Provider Business Practice Location Address
First Line	:	807 N EASTON RD
Second Line	:	SUITE 105
City	:	DOYLESTOWN
State	:	PA
Zip	:	18901-1044
Country	:	US
Telephone Number	:	215-340-2322
Fax Number	:	215-340-9915

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

Provider Enumeration Date	:	08/14/2006
Last Update Date	:	07/08/2007

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