Provider Demographics
NPI:1972336063
Name:SANFORD, KAYLEE ANN (DPT)
Entity type:Individual
Prefix:
First Name:KAYLEE
Middle Name:ANN
Last Name:SANFORD
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:355 MORGAN LN
Mailing Address - Street 2:
Mailing Address - City:MARGARETVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:12455-2306
Mailing Address - Country:US
Mailing Address - Phone:845-901-3182
Mailing Address - Fax:
Practice Address - Street 1:501 DOUGLAS ST
Practice Address - Street 2:
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27705-3888
Practice Address - Country:US
Practice Address - Phone:919-684-2445
Practice Address - Fax:919-660-9249
Is Sole Proprietor?:No
Enumeration Date:2024-08-23
Last Update Date:2024-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCP23580225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist