MEDICARE: SANDRA G KAMMERZELL MS, PT

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	880	AK

General Provider Information

NPI Number	:	1548843238
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SANDRA G KAMMERZELL MS, PT

Provider Business Mailing Address
First Line	:	807 HORSESHOE FALLS DR
Second Line	:
City	:	ORLANDO
State	:	FL
Zip	:	32828-6652
Country	:	US
Telephone Number	:	407-730-5020
Fax Number	:

Provider Business Practice Location Address
First Line	:	807 HORSESHOE FALLS DR
Second Line	:
City	:	ORLANDO
State	:	FL
Zip	:	32828-6652
Country	:	US
Telephone Number	:	407-730-5020
Fax Number	:

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

Provider Enumeration Date	:	04/30/2021
Last Update Date	:	04/30/2021

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