Provider Demographics
NPI:1568822260
Name:VAGTS, SANDRA (PT, MBA, CKTP, CLT)
Entity Type:Individual
Prefix:
First Name:SANDRA
Middle Name:
Last Name:VAGTS
Suffix:
Gender:F
Credentials:PT, MBA, CKTP, CLT
Other - Prefix:
Other - First Name:SANDRA
Other - Middle Name:
Other - Last Name:MUEHLENTHALER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:13622 NE 14TH ST
Mailing Address - Street 2:
Mailing Address - City:ALLEMAN
Mailing Address - State:IA
Mailing Address - Zip Code:50007
Mailing Address - Country:US
Mailing Address - Phone:515-250-4787
Mailing Address - Fax:
Practice Address - Street 1:13622 NE 14TH ST
Practice Address - Street 2:
Practice Address - City:ALLEMAN
Practice Address - State:IA
Practice Address - Zip Code:50007
Practice Address - Country:US
Practice Address - Phone:515-250-4787
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-02-24
Last Update Date:2016-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA01315225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist