MEDICARE: CHRISTY LEE SANDS PT, DPT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225100000X	Physical Therapist	62850	OR

General Provider Information

NPI Number	:	1255809547
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHRISTY LEE SANDS PT, DPT

Provider Business Mailing Address
First Line	:	PO BOX 1397
Second Line	:
City	:	BEND
State	:	OR
Zip	:	97709-1397
Country	:	US
Telephone Number	:	541-389-1848
Fax Number	:	541-550-7956

Provider Business Practice Location Address
First Line	:	2125 NE DAGGETT LN
Second Line	:
City	:	BEND
State	:	OR
Zip	:	97701-6560
Country	:	US
Telephone Number	:	541-389-1848
Fax Number	:	541-550-7956

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/05/2018
Last Update Date	:	11/05/2018

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