Provider Demographics
NPI:1194007526
Name:SANDERS, ARLEE ANN (PTA)
Entity Type:Individual
Prefix:MRS
First Name:ARLEE
Middle Name:ANN
Last Name:SANDERS
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:MISS
Other - First Name:ARLEE
Other - Middle Name:ANN
Other - Last Name:RUTTER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:4671 SPRING LN
Mailing Address - Street 2:
Mailing Address - City:MOUNT PLEASANT
Mailing Address - State:MI
Mailing Address - Zip Code:48858-8297
Mailing Address - Country:US
Mailing Address - Phone:989-506-2190
Mailing Address - Fax:
Practice Address - Street 1:4671 SPRING LN
Practice Address - Street 2:
Practice Address - City:MOUNT PLEASANT
Practice Address - State:MI
Practice Address - Zip Code:48858-8297
Practice Address - Country:US
Practice Address - Phone:989-506-2190
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-09-12
Last Update Date:2011-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5502003268225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant