Healthcare Provider Details

I. General information

NPI: 1851530174
Provider Name (Legal Business Name): LACINDA GAYETT SANCHEZ PHYSICAL THERAPIST
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: LACINDA GAYETT SMITH P.T

II. Dates (important events)

Enumeration Date: 02/10/2009
Last Update Date: 02/10/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16483 N. 2300 RD RT 2, BOX 29C
SNYDER OK
73566
US

IV. Provider business mailing address

RT 2 BOX 29C
SNYDER OK
73566
US

V. Phone/Fax

Practice location:
  • Phone: 580-351-4092
  • Fax:
Mailing address:
  • Phone: 580-351-4092
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number1534
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: