Healthcare Provider Details

I. General information

NPI: 1790696839
Provider Name (Legal Business Name): REAGAN KAY SANBORN PT, DPT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/16/2026
Last Update Date: 09/16/2026
Certification Date: 09/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5275 MACKINAW RD
SAGINAW MI
48603-1223
US

IV. Provider business mailing address

3777 LAMPLIGHTER DR
SAGINAW MI
48603-8657
US

V. Phone/Fax

Practice location:
  • Phone: 248-563-6519
  • Fax:
Mailing address:
  • Phone: 248-563-6519
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2251G0304X
TaxonomyGeriatric Physical Therapist
License Number5501304700
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: