Healthcare Provider Details

I. General information

NPI: 1952586372
Provider Name (Legal Business Name): SANDS GROUP, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/03/2008
Last Update Date: 01/03/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1555 N MAIN ST
FRANKFORT IN
46041-1167
US

IV. Provider business mailing address

1121 MILITARY CUTOFF RD STE C #345
WILMINGTON NC
28405-3658
US

V. Phone/Fax

Practice location:
  • Phone: 765-654-0871
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP2000X
TaxonomyPhysical Therapy Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MARK JORDAN
Title or Position: PRESIDENT
Credential:
Phone: 765-654-0871