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NPI Code Detail

MEDICARE: SUZANNE R SANDSMARK RPT

MEDICARE:   SUZANNE R SANDSMARK  RPT
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 Therapist2824MN
2225100000XPhysical Therapist538ND

Other Identifiers

General Provider Information

NPI Number : 1952336265
Entity Type Code : Individual
Provider Name (Legal Business Name) : SUZANNE R SANDSMARK RPT
Provider Business Mailing Address
First Line : PO BOX 5074
Second Line :
City : SIOUX FALLS
State : SD
Zip : 57117-5074
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 3838 12TH AVE N
Second Line :
City : FARGO
State : ND
Zip : 58102-2931
Country : US
Telephone Number : 701-234-4700
Fax Number : 701-234-4757
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/12/2006
Last Update Date : 11/09/2023

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Directions to “ SUZANNE R SANDSMARK RPT” Practice Location

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