Provider Demographics
NPI:1992980775
Name:SAUNDERS, MICHELE (PT)
Entity type:Individual
Prefix:
First Name:MICHELE
Middle Name:
Last Name:SAUNDERS
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 1:74 OLD FORGE HOLLOW RD
Mailing Address - Street 2:
Mailing Address - City:BANTAM
Mailing Address - State:CT
Mailing Address - Zip Code:06750-1315
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:350 LITCHFIELD RD
Practice Address - Street 2:
Practice Address - City:NEW MILFORD
Practice Address - State:CT
Practice Address - Zip Code:06776-2003
Practice Address - Country:US
Practice Address - Phone:860-355-5373
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-12-31
Last Update Date:2013-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY018770-12251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic