Provider Demographics
NPI:1154465615
Name:SANKOVICH, KANDRA ROGERSON (MS, ATC, CPT)
Entity type:Individual
Prefix:MRS
First Name:KANDRA
Middle Name:ROGERSON
Last Name:SANKOVICH
Suffix:
Gender:F
Credentials:MS, ATC, CPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:121 MEADOWVIEW CT
Mailing Address - Street 2:
Mailing Address - City:UNIONTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:15401-8700
Mailing Address - Country:US
Mailing Address - Phone:724-439-4020
Mailing Address - Fax:
Practice Address - Street 1:84 N GALLATIN AVE
Practice Address - Street 2:
Practice Address - City:UNIONTOWN
Practice Address - State:PA
Practice Address - Zip Code:15401-3009
Practice Address - Country:US
Practice Address - Phone:724-437-7500
Practice Address - Fax:724-437-4492
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PART001816A2255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer