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General NPI Number Information
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NPI Number | 1487955258
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Entity Type | Individual
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Provider Name | MR. ROBERT C SANDERS
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Gender | Male
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Dates
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Enumeration Date | 11/10/2010
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Last Update Date | 11/10/2010
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Provider Practice Location Address
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Address Line | 1 MT CARMEL WAY
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City | PITTSBURG
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State | KS
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Zip | 66762-7587
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Country | US
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Telephone | 620-232-0229
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Fax |
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Provider Business Mailing Address
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Address Line | 691 SW 137TH LN
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City | ASBURY
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State | MO
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Zip | 64832-8156
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Country | US
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Telephone | 417-842-3663
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Fax |
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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 | 225200000X
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Taxonomy Name | Physical Therapy Assistant
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License Number | 14-02187
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License Number State | KS
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