Provider Demographics
NPI:1619098217
Name:BOVE, SANDRA S (OTR, MED)
Entity Type:Individual
Prefix:MS
First Name:SANDRA
Middle Name:S
Last Name:BOVE
Suffix:
Gender:F
Credentials:OTR, MED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13 ADAMS RD
Mailing Address - Street 2:
Mailing Address - City:BRANDON
Mailing Address - State:VT
Mailing Address - Zip Code:05733-8408
Mailing Address - Country:US
Mailing Address - Phone:802-247-5998
Mailing Address - Fax:
Practice Address - Street 1:13 ADAMS RD
Practice Address - Street 2:
Practice Address - City:BRANDON
Practice Address - State:VT
Practice Address - Zip Code:05733-8408
Practice Address - Country:US
Practice Address - Phone:802-247-5998
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
28332 AND 19060OtherPROVIDER NUMBERS