Provider Demographics
NPI:1578231114
Name:COWARD, SANDRA (PT, DPT)
Entity Type:Individual
Prefix:
First Name:SANDRA
Middle Name:
Last Name:COWARD
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:SANDRA
Other - Middle Name:
Other - Last Name:STURDIVANT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:9449 GLENBURN LN
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28278-7907
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:8919 PARK RD
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28210-9600
Practice Address - Country:US
Practice Address - Phone:704-551-6800
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-08-30
Last Update Date:2021-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCPT15452225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist