Provider Demographics
NPI:1003825902
Name:BOND, SANDRA MARIE
Entity Type:Individual
Prefix:
First Name:SANDRA
Middle Name:MARIE
Last Name:BOND
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2712 SPRING GARDEN ST
Mailing Address - Street 2:
Mailing Address - City:LEAVENWORTH
Mailing Address - State:KS
Mailing Address - Zip Code:66048-6710
Mailing Address - Country:US
Mailing Address - Phone:913-758-0155
Mailing Address - Fax:
Practice Address - Street 1:2712 SPRING GARDEN ST
Practice Address - Street 2:
Practice Address - City:LEAVENWORTH
Practice Address - State:KS
Practice Address - Zip Code:66048-6710
Practice Address - Country:US
Practice Address - Phone:913-758-0155
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225800000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRecreation Therapist