Provider Demographics
NPI:1225355159
Name:MCCOOL, SANDRA (PT)
Entity Type:Individual
Prefix:
First Name:SANDRA
Middle Name:
Last Name:MCCOOL
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:16 INDUSTRIAL BLVD
Mailing Address - Street 2:203
Mailing Address - City:PAOLI
Mailing Address - State:PA
Mailing Address - Zip Code:19301-1609
Mailing Address - Country:US
Mailing Address - Phone:484-595-9300
Mailing Address - Fax:484-593-0365
Practice Address - Street 1:5830 ELLSWORTH AVE
Practice Address - Street 2:201
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15232-1778
Practice Address - Country:US
Practice Address - Phone:484-595-9300
Practice Address - Fax:484-593-0365
Is Sole Proprietor?:Yes
Enumeration Date:2010-05-03
Last Update Date:2010-05-03
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PAPT010859L225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist