Provider Demographics
NPI:1124660725
Name:SANCHEZ, OTTO ALEXANDER (PHD)
Entity type:Individual
Prefix:DR
First Name:OTTO
Middle Name:ALEXANDER
Last Name:SANCHEZ
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Gender:M
Credentials:PHD
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Mailing Address - Street 1:393 DUNLAP ST N STE LL34
Mailing Address - Street 2:
Mailing Address - City:SAINT PAUL
Mailing Address - State:MN
Mailing Address - Zip Code:55104-4202
Mailing Address - Country:US
Mailing Address - Phone:651-644-6002
Mailing Address - Fax:651-747-1647
Practice Address - Street 1:393 DUNLAP ST N STE LL34
Practice Address - Street 2:
Practice Address - City:SAINT PAUL
Practice Address - State:MN
Practice Address - Zip Code:55104-4202
Practice Address - Country:US
Practice Address - Phone:651-644-6002
Practice Address - Fax:651-747-1647
Is Sole Proprietor?:No
Enumeration Date:2019-10-15
Last Update Date:2019-10-15
Deactivation Date:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Y00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersClinical Exercise Physiologist