Provider Demographics
NPI:1508072935
Name:LLOYD, SANDRA VONTHIA (LMT)
Entity Type:Individual
Prefix:MRS
First Name:SANDRA
Middle Name:VONTHIA
Last Name:LLOYD
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:MS
Other - First Name:SANDRA
Other - Middle Name:VONTHIA
Other - Last Name:LAWSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LMT
Mailing Address - Street 1:12672 PETERSBURG ST
Mailing Address - Street 2:
Mailing Address - City:CHESTER
Mailing Address - State:VA
Mailing Address - Zip Code:23831-5025
Mailing Address - Country:US
Mailing Address - Phone:804-425-7144
Mailing Address - Fax:804-425-7144
Practice Address - Street 1:12672 PETERSBURG ST
Practice Address - Street 2:
Practice Address - City:CHESTER
Practice Address - State:VA
Practice Address - Zip Code:23831-5025
Practice Address - Country:US
Practice Address - Phone:804-425-7144
Practice Address - Fax:804-425-7144
Is Sole Proprietor?:No
Enumeration Date:2007-05-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY009944225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist