Provider Demographics
NPI:1104165059
Name:GARCIA, SANDRA (MPT)
Entity type:Individual
Prefix:
First Name:SANDRA
Middle Name:
Last Name:GARCIA
Suffix:
Gender:F
Credentials:MPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14659 E EVANS AVE
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:CO
Mailing Address - Zip Code:80014-1533
Mailing Address - Country:US
Mailing Address - Phone:303-745-0011
Mailing Address - Fax:
Practice Address - Street 1:14659 E EVANS AVE
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80014-1533
Practice Address - Country:US
Practice Address - Phone:303-745-0011
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-02-12
Last Update Date:2013-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO5831225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist