Provider Demographics
NPI:1336330299
Name:SANDS, PEGGY OWEN (PT, MS)
Entity Type:Individual
Prefix:
First Name:PEGGY
Middle Name:OWEN
Last Name:SANDS
Suffix:
Gender:F
Credentials:PT, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7 LEDGEMERE ST
Mailing Address - Street 2:
Mailing Address - City:BURLINGTON
Mailing Address - State:VT
Mailing Address - Zip Code:05401-4822
Mailing Address - Country:US
Mailing Address - Phone:802-658-3258
Mailing Address - Fax:
Practice Address - Street 1:40 HIGH ST
Practice Address - Street 2:
Practice Address - City:MIDDLEBURY
Practice Address - State:VT
Practice Address - Zip Code:05753-1209
Practice Address - Country:US
Practice Address - Phone:802-388-1153
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-08-06
Last Update Date:2007-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT040-00024922251P0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251P0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistPediatrics