Provider Demographics
NPI:1366558066
Name:GOLDRING, SANDI (PT)
Entity type:Individual
Prefix:
First Name:SANDI
Middle Name:
Last Name:GOLDRING
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2145 SERPENTINE DR NE
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30345-3622
Mailing Address - Country:US
Mailing Address - Phone:770-668-3636
Mailing Address - Fax:206-338-6428
Practice Address - Street 1:3 DUNWOODY PARK
Practice Address - Street 2:
Practice Address - City:DUNWOODY
Practice Address - State:GA
Practice Address - Zip Code:30338-7405
Practice Address - Country:US
Practice Address - Phone:770-668-3636
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-23
Last Update Date:2009-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA004365225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist