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NPI Code Detail

MEDICARE: MRS. MARIE T SARDLER PT

MEDICARE:  MRS. MARIE T SARDLER  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
1225100000XPhysical TherapistP8620NC

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1133KEOTHERNCBCBS

General Provider Information

NPI Number : 1679557946
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. MARIE T SARDLER PT
Provider Business Mailing Address
First Line : 4601 PARK RD STE 300
Second Line :
City : CHARLOTTE
State : NC
Zip : 28209-2290
Country : US
Telephone Number : 704-323-2248
Fax Number :
Provider Business Practice Location Address
First Line : 402 W KING ST
Second Line :
City : KING
State : NC
Zip : 27021-9170
Country : US
Telephone Number : 336-659-3705
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/01/2005
Last Update Date : 07/05/2019

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Directions to “ MRS. MARIE T SARDLER PT” Practice Location

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