Provider Demographics
NPI:1215069398
Name:JANIDES, SANDY LYNN (DPT)
Entity type:Individual
Prefix:MRS
First Name:SANDY
Middle Name:LYNN
Last Name:JANIDES
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:SANDY
Other - Middle Name:
Other - Last Name:JASPER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1619 E DRURY LN
Mailing Address - Street 2:
Mailing Address - City:OLATHE
Mailing Address - State:KS
Mailing Address - Zip Code:66062-1840
Mailing Address - Country:US
Mailing Address - Phone:913-485-8737
Mailing Address - Fax:
Practice Address - Street 1:2300 N 113TH TER
Practice Address - Street 2:
Practice Address - City:KANSAS CITY
Practice Address - State:KS
Practice Address - Zip Code:66109-3786
Practice Address - Country:US
Practice Address - Phone:913-400-7006
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-12
Last Update Date:2024-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS0333174400000X
KS11-03333225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
No174400000XOther Service ProvidersSpecialist