Provider Demographics
NPI:1699709998
Name:SANDERS, PATRICIA (PT)
Entity type:Individual
Prefix:
First Name:PATRICIA
Middle Name:
Last Name:SANDERS
Suffix:
Gender:F
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:PO BOX 222
Mailing Address - Street 2:
Mailing Address - City:DENALI PARK
Mailing Address - State:AK
Mailing Address - Zip Code:99755-0222
Mailing Address - Country:US
Mailing Address - Phone:907-683-4240
Mailing Address - Fax:907-683-4240
Practice Address - Street 1:15B REVINE CREEK TRAIL
Practice Address - Street 2:
Practice Address - City:DENALI NATIONAL PARK
Practice Address - State:AK
Practice Address - Zip Code:99755
Practice Address - Country:US
Practice Address - Phone:907-683-4240
Practice Address - Fax:907-683-4240
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-10
Last Update Date:2014-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK1474225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist