Healthcare Provider Details

I. General information

NPI: 1982817938
Provider Name (Legal Business Name): SANDRA ANN ZIMDARS PHYSICAL THERAPIST
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/07/2007
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

305 S CLARK ST
MAYVILLE WI
53050-1488
US

IV. Provider business mailing address

8409 HILLTOP LN
KEWASKUM WI
53040-9229
US

V. Phone/Fax

Practice location:
  • Phone: 920-387-1370
  • Fax:
Mailing address:
  • Phone: 262-334-4516
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number9913-024
License Number StateWI
# 2
Primary TaxonomyN
Taxonomy Code2251G0304X
TaxonomyGeriatric Physical Therapist
License Number9913-024
License Number StateWI
# 3
Primary TaxonomyY
Taxonomy Code2251N0400X
TaxonomyNeurology Physical Therapist
License Number9913-024
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: