MEDICARE: MS. CARLEEN ANN SAJKOWSKY P.T.

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	4097	NM
2	225100000X	Physical Therapist	1-7667-7	TX
3	225100000X	Physical Therapist	1076677	TX

General Provider Information

NPI Number	:	1275550170
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. CARLEEN ANN SAJKOWSKY P.T.

Provider Business Mailing Address
First Line	:	2455 MISSOURI AVE
Second Line	:	SUITE B
City	:	LAS CRUCES
State	:	NM
Zip	:	88001-5122
Country	:	US
Telephone Number	:	575-556-8440
Fax Number	:	575-556-8439

Provider Business Practice Location Address
First Line	:	2455 MISSOURI AVE
Second Line	:	SUITE B
City	:	LAS CRUCES
State	:	NM
Zip	:	88001-5122
Country	:	US
Telephone Number	:	575-556-8440
Fax Number	:	575-556-8439

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

Provider Enumeration Date	:	07/16/2006
Last Update Date	:	05/01/2015

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