Provider Demographics
NPI:1154692416
Name:SANCHEZ, LISA BRITTANY (DPT)
Entity type:Individual
Prefix:MRS
First Name:LISA
Middle Name:BRITTANY
Last Name:SANCHEZ
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13691 PINEVIEW LN N
Mailing Address - Street 2:
Mailing Address - City:DAYTON
Mailing Address - State:MN
Mailing Address - Zip Code:55327-9461
Mailing Address - Country:US
Mailing Address - Phone:763-496-7881
Mailing Address - Fax:
Practice Address - Street 1:13691 PINEVIEW LN N
Practice Address - Street 2:
Practice Address - City:DAYTON
Practice Address - State:MN
Practice Address - Zip Code:55327-9461
Practice Address - Country:US
Practice Address - Phone:763-496-7881
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-01-18
Last Update Date:2019-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN8635225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN1154692416Medicaid