Provider Demographics
NPI:1669503934
Name:GARBER, SANDRA G (PT)
Entity Type:Individual
Prefix:
First Name:SANDRA
Middle Name:G
Last Name:GARBER
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:SANDRA
Other - Middle Name:G
Other - Last Name:REINOLD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT
Mailing Address - Street 1:150 PRESIDENTIAL WAY
Mailing Address - Street 2:SUITE 110
Mailing Address - City:WOBURN
Mailing Address - State:MA
Mailing Address - Zip Code:01801-1100
Mailing Address - Country:US
Mailing Address - Phone:781-782-1300
Mailing Address - Fax:781-782-1350
Practice Address - Street 1:150 PRESIDENTIAL WAY
Practice Address - Street 2:SUITE 110
Practice Address - City:WOBURN
Practice Address - State:MA
Practice Address - Zip Code:01801-1100
Practice Address - Country:US
Practice Address - Phone:781-782-1300
Practice Address - Fax:781-782-1350
Is Sole Proprietor?:No
Enumeration Date:2007-03-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA15354225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA15354OtherSTATE LICENSE NUMBER