Provider Demographics
NPI:1750836904
Name:SANII, AMIR REZA (PT)
Entity Type:Individual
Prefix:
First Name:AMIR
Middle Name:REZA
Last Name:SANII
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:AMIR
Other - Middle Name:
Other - Last Name:SANII
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 603949
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28260-3949
Mailing Address - Country:US
Mailing Address - Phone:919-350-8991
Mailing Address - Fax:919-350-7687
Practice Address - Street 1:120 HEALTHPLEX WAY
Practice Address - Street 2:
Practice Address - City:APEX
Practice Address - State:NC
Practice Address - Zip Code:27502-8403
Practice Address - Country:US
Practice Address - Phone:919-882-6578
Practice Address - Fax:919-232-5021
Is Sole Proprietor?:No
Enumeration Date:2016-08-17
Last Update Date:2022-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCP16512225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist