Provider Demographics
NPI:1558674630
Name:BYLE, SANDRA L (LAT/ATC)
Entity Type:Individual
Prefix:
First Name:SANDRA
Middle Name:L
Last Name:BYLE
Suffix:
Gender:F
Credentials:LAT/ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8607 E 300 S
Mailing Address - Street 2:
Mailing Address - City:ZIONSVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:46077-9436
Mailing Address - Country:US
Mailing Address - Phone:317-769-4484
Mailing Address - Fax:
Practice Address - Street 1:8607 E 300 S
Practice Address - Street 2:
Practice Address - City:ZIONSVILLE
Practice Address - State:IN
Practice Address - Zip Code:46077-9436
Practice Address - Country:US
Practice Address - Phone:317-769-4484
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-07-19
Last Update Date:2010-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN36000564A282N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital