Provider Demographics
NPI:1114335510
Name:RENDE, SANDRA GRACE (PT)
Entity Type:Individual
Prefix:MS
First Name:SANDRA
Middle Name:GRACE
Last Name:RENDE
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:101 MANNING DR
Mailing Address - Street 2:DEPARTMENT OF PT/OT
Mailing Address - City:CHAPEL HILL
Mailing Address - State:NC
Mailing Address - Zip Code:27514-4220
Mailing Address - Country:US
Mailing Address - Phone:919-799-4510
Mailing Address - Fax:919-799-4691
Practice Address - Street 1:163 MEDICAL PARK DR
Practice Address - Street 2:
Practice Address - City:SILER CITY
Practice Address - State:NC
Practice Address - Zip Code:27344-6790
Practice Address - Country:US
Practice Address - Phone:919-799-4510
Practice Address - Fax:919-799-4691
Is Sole Proprietor?:No
Enumeration Date:2014-07-29
Last Update Date:2020-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCP14905225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist