Provider Demographics
NPI:1992598247
Name:SANCHEZ, ANDRES TAYLOR (DPT)
Entity type:Individual
Prefix:
First Name:ANDRES
Middle Name:TAYLOR
Last Name:SANCHEZ
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:ANDY
Other - Middle Name:
Other - Last Name:SANCHEZ
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:NICK NAME
Mailing Address - Street 1:1673 W SHORELINE DR STE 230
Mailing Address - Street 2:
Mailing Address - City:BOISE
Mailing Address - State:ID
Mailing Address - Zip Code:83702-6752
Mailing Address - Country:US
Mailing Address - Phone:208-939-9594
Mailing Address - Fax:208-939-9828
Practice Address - Street 1:904 S VANGUARD WAY STE 110
Practice Address - Street 2:
Practice Address - City:MERIDIAN
Practice Address - State:ID
Practice Address - Zip Code:83642-7552
Practice Address - Country:US
Practice Address - Phone:208-803-6767
Practice Address - Fax:208-803-6166
Is Sole Proprietor?:No
Enumeration Date:2025-05-28
Last Update Date:2025-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ID2171263225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist