Provider Demographics
NPI:1588918692
Name:SANSOTTA, NOEL N (PT)
Entity type:Individual
Prefix:
First Name:NOEL
Middle Name:N
Last Name:SANSOTTA
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:NOEL
Other - Middle Name:N
Other - Last Name:LANDKAMMER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT
Mailing Address - Street 1:PO BOX 32709
Mailing Address - Street 2:
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37930-2709
Mailing Address - Country:US
Mailing Address - Phone:865-558-6484
Mailing Address - Fax:865-584-4037
Practice Address - Street 1:8904 CROSS PARK DR
Practice Address - Street 2:
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37923-4703
Practice Address - Country:US
Practice Address - Phone:865-690-2671
Practice Address - Fax:865-690-6445
Is Sole Proprietor?:No
Enumeration Date:2012-10-29
Last Update Date:2013-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN94532251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN1031654008OtherMEDICARE PTAN