MEDICARE: MR. SANDRA L LANNING 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	PT23299	FL

General Provider Information

NPI Number	:	1922268648
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. SANDRA L LANNING PT

Provider Business Mailing Address
First Line	:	13711 FLINTLOCK DR
Second Line	:
City	:	SPRING HILL
State	:	FL
Zip	:	34609-0727
Country	:	US
Telephone Number	:	352-263-5965
Fax Number	:

Provider Business Practice Location Address
First Line	:	3385 MARINER BLVD
Second Line	:
City	:	SPRING HILL
State	:	FL
Zip	:	34609-2461
Country	:	US
Telephone Number	:	352-683-8882
Fax Number	:

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

Provider Enumeration Date	:	06/16/2008
Last Update Date	:	06/16/2008

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