Healthcare Provider Details

I. General information

NPI: 1740275726
Provider Name (Legal Business Name): CATHY T. SANFORD P.T.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/15/2005
Last Update Date: 10/21/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

600 WHITESPORT DR STE C
HUNTSVILLE AL
35801
US

IV. Provider business mailing address

600 WHITESPORT DR STE C
HUNTSVILLE AL
35801
US

V. Phone/Fax

Practice location:
  • Phone: 256-882-2003
  • Fax: 256-512-0943
Mailing address:
  • Phone: 256-882-2003
  • Fax: 256-512-0943

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPTH197
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: