Provider Demographics
NPI:1386080901
Name:SANCHEZ, ALEJANDRA C (LMT)
Entity type:Individual
Prefix:
First Name:ALEJANDRA
Middle Name:C
Last Name:SANCHEZ
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1174 E GRAYSTONE WAY
Mailing Address - Street 2:SUITE 9
Mailing Address - City:SALT LAKE CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84106-2673
Mailing Address - Country:US
Mailing Address - Phone:801-638-5496
Mailing Address - Fax:
Practice Address - Street 1:1174 E GRAYSTONE WAY
Practice Address - Street 2:SUITE 9
Practice Address - City:SALT LAKE CITY
Practice Address - State:UT
Practice Address - Zip Code:84106-2673
Practice Address - Country:US
Practice Address - Phone:801-638-5496
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-05-22
Last Update Date:2013-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT5505528-4701173C00000X, 225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist
No173C00000XOther Service ProvidersReflexologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
UT45-2271309OtherIRS