Provider Demographics
NPI:1730389636
Name:SAJDAK, BETSY ANN (MBA, PT)
Entity type:Individual
Prefix:MRS
First Name:BETSY
Middle Name:ANN
Last Name:SAJDAK
Suffix:
Gender:F
Credentials:MBA, PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15123 ROMALONG LN
Mailing Address - Street 2:
Mailing Address - City:CARMEL
Mailing Address - State:IN
Mailing Address - Zip Code:46032-5103
Mailing Address - Country:US
Mailing Address - Phone:317-846-2524
Mailing Address - Fax:
Practice Address - Street 1:8180 CLEARVISTA PKWY STE 101
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46256-4649
Practice Address - Country:US
Practice Address - Phone:317-621-2212
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-19
Last Update Date:2007-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN05003221A225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist