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General NPI Number Information
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NPI Number | 1922079003
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Entity Type | Individual
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Provider Name | ZANTHA ELAINE SANDERLIN MS,PT
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Gender | Female
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Dates
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Enumeration Date | 01/27/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 9815 WESTWOOD RD
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City | MOUNTAINBURG
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State | AR
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Zip | 72946-3278
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Country | US
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Telephone | 479-369-4456
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Fax |
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Provider Business Mailing Address
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Address Line | 4322 W BEAVER LN
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City | FAYETTEVILLE
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State | AR
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Zip | 72704-5535
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Country | US
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Telephone | 479-571-1875
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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 | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | PT2402
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License Number State | AR
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