Provider Demographics
NPI:1477610731
Name:ZACCARI, SANDRA CONSTANCE (PT)
Entity Type:Individual
Prefix:
First Name:SANDRA
Middle Name:CONSTANCE
Last Name:ZACCARI
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 1:6004 DEERBROOK DR
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37221-4094
Mailing Address - Country:US
Mailing Address - Phone:615-646-0170
Mailing Address - Fax:
Practice Address - Street 1:1647 MALLORY LN
Practice Address - Street 2:SUITE 103
Practice Address - City:BRENTWOOD
Practice Address - State:TN
Practice Address - Zip Code:37027-2909
Practice Address - Country:US
Practice Address - Phone:615-661-5437
Practice Address - Fax:615-309-8342
Is Sole Proprietor?:No
Enumeration Date:2007-01-03
Last Update Date:2009-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
2251P0200X
TN6837225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251P0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistPediatrics
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist