Provider Demographics
NPI:1427269208
Name:KNUST, SANDRA J (PT)
Entity type:Individual
Prefix:MRS
First Name:SANDRA
Middle Name:J
Last Name:KNUST
Suffix:
Gender:F
Credentials:PT
Other - Prefix:MRS
Other - First Name:SANDY
Other - Middle Name:J
Other - Last Name:KNUST
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PT
Mailing Address - Street 1:103 SOUTH COUNTY ROAD
Mailing Address - Street 2:
Mailing Address - City:PLYMOUTH
Mailing Address - State:NE
Mailing Address - Zip Code:68424
Mailing Address - Country:US
Mailing Address - Phone:402-656-4395
Mailing Address - Fax:
Practice Address - Street 1:1200 N 6TH ST
Practice Address - Street 2:STE B
Practice Address - City:BEATRICE
Practice Address - State:NE
Practice Address - Zip Code:68310-2062
Practice Address - Country:US
Practice Address - Phone:402-228-1222
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE683225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist