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NPI Code Detail

MEDICARE: MARSHALL W SANDERLIN DPT

MEDICARE: MARSHALL W SANDERLIN 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
1225100000XPhysical Therapist1373595TX
2225100000XPhysical Therapist12122RLA

General Provider Information

NPI Number : 1811698988
Entity Type Code : Individual
Provider Name (Legal Business Name) : MARSHALL W SANDERLIN DPT
Provider Business Mailing Address
First Line : 663 JORDAN ST
Second Line :
City : SHREVEPORT
State : LA
Zip : 71101-4748
Country : US
Telephone Number : 318-222-8892
Fax Number : 318-222-8893
Provider Business Practice Location Address
First Line : 4970 BARKSDALE BLVD STE 900
Second Line :
City : BOSSIER CITY
State : LA
Zip : 71112-4677
Country : US
Telephone Number : 318-747-8892
Fax Number : 318-747-8893
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/15/2023
Last Update Date : 02/19/2026

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Directions to “ MARSHALL W SANDERLIN DPT” Practice Location

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