Provider Demographics
NPI:1346390135
Name:ARMSTRONG, SANDY KAY
Entity Type:Individual
Prefix:
First Name:SANDY
Middle Name:KAY
Last Name:ARMSTRONG
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 1:118 S TAYLOR ST
Mailing Address - Street 2:
Mailing Address - City:MT.AYR
Mailing Address - State:IA
Mailing Address - Zip Code:50845
Mailing Address - Country:US
Mailing Address - Phone:641-464-3651
Mailing Address - Fax:641-464-3651
Practice Address - Street 1:118 S TAYLOR ST
Practice Address - Street 2:
Practice Address - City:MOUNT AYR
Practice Address - State:IA
Practice Address - Zip Code:50854-1829
Practice Address - Country:US
Practice Address - Phone:641-464-3651
Practice Address - Fax:641-464-3651
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA156FX1800X156FX1800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOptician
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA0265637Medicaid
4560370001Medicare ID - Type Unspecified