Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225100000X | Physical Therapist | 2305001637 | VA |
N | 2251H1200X | Hand | 9209001478 | VA |
NPI | 1174583520 |
---|---|
Provider Name | Mrs. Sandra R Saunders |
First Address | North Chesterfield, VA 23225-4067 |
Second Address | Richmond, VA 23235-4765 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/03/2006 |
Last Update Date | 16/09/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1174583520 | (05) | VA |
P00810128 | RR MEDICARE (01) | VA |