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General NPI Number Information
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NPI Number | 1447586656
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Entity Type | Individual
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Provider Name | MARCIA L SANDERSON PT
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Gender | Female
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Dates
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Enumeration Date | 10/22/2009
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Last Update Date | 04/12/2017
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Provider Practice Location Address
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Address Line | 25 PLAZA DR. UNIT 6
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City | SCARBOROUGH
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State | ME
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Zip | 04074
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Country | US
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Telephone | 207-289-1010
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Fax | 207-289-1011
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Provider Business Mailing Address
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Address Line | 25 PLAZA DR. UNIT 6
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City | SCARBOROUGH
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State | ME
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Zip | 04074
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Country | US
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Telephone | 207-289-1010
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Fax | 207-289-1011
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | PT292
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License Number State | ME
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Taxonomy #2
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Taxonomy Code | 225700000X
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Taxonomy Name | Massage Therapist
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License Number | MT3823
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License Number State | ME
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