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General NPI Number Information
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NPI Number | 1992598247
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Entity Type | Individual
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Provider Name | ANDRES TAYLOR SANCHEZ DPT
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Gender | Male
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Dates
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Enumeration Date | 05/28/2025
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Last Update Date | 05/28/2025
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Provider Practice Location Address
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Address Line | 904 S VANGUARD WAY STE 110
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City | MERIDIAN
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State | ID
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Zip | 83642-7552
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Country | US
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Telephone | 208-803-6767
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Fax | 208-803-6166
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Provider Business Mailing Address
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Address Line | 1673 W SHORELINE DR STE 230
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City | BOISE
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State | ID
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Zip | 83702-6752
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Country | US
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Telephone | 208-939-9594
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Fax | 208-939-9828
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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 | 2171263
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License Number State | ID
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