Provider Demographics
NPI:1902055585
Name:SANDERS, ANN M (PT)
Entity Type:Individual
Prefix:MRS
First Name:ANN
Middle Name:M
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 1:691 SW 137TH LN
Mailing Address - Street 2:
Mailing Address - City:ASBURY
Mailing Address - State:MO
Mailing Address - Zip Code:64832-8156
Mailing Address - Country:US
Mailing Address - Phone:417-842-3662
Mailing Address - Fax:
Practice Address - Street 1:691 SW 137TH LN
Practice Address - Street 2:
Practice Address - City:ASBURY
Practice Address - State:MO
Practice Address - Zip Code:64832-8156
Practice Address - Country:US
Practice Address - Phone:417-842-3662
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-09-18
Last Update Date:2008-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS11-01227225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist