Provider Demographics
NPI:1245287069
Name:SAYLER, TAMMY LEIGH (MPT)
Entity type:Individual
Prefix:
First Name:TAMMY
Middle Name:LEIGH
Last Name:SAYLER
Suffix:
Gender:F
Credentials:MPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:156 VICTORIA CT
Mailing Address - Street 2:
Mailing Address - City:GRAND FORKS
Mailing Address - State:ND
Mailing Address - Zip Code:58201-6145
Mailing Address - Country:US
Mailing Address - Phone:701-780-0919
Mailing Address - Fax:
Practice Address - Street 1:2951 S 34TH ST
Practice Address - Street 2:
Practice Address - City:GRAND FORKS
Practice Address - State:ND
Practice Address - Zip Code:58201-6061
Practice Address - Country:US
Practice Address - Phone:701-772-3851
Practice Address - Fax:701-772-3852
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-27
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ND10712251P0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251P0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
ND26626OtherBLUE SHIELD PROVIDER #
ND51030Medicaid
ND51018Medicaid