Provider Demographics
NPI:1780633057
Name:HENDRICH, SANDRA DARLENE (PT)
Entity Type:Individual
Prefix:
First Name:SANDRA
Middle Name:DARLENE
Last Name:HENDRICH
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3861 W COUNTY ROAD 600 N
Mailing Address - Street 2:
Mailing Address - City:BRAZIL
Mailing Address - State:IN
Mailing Address - Zip Code:47834-7434
Mailing Address - Country:US
Mailing Address - Phone:812-448-8798
Mailing Address - Fax:
Practice Address - Street 1:3861 W COUNTY ROAD 600 N
Practice Address - Street 2:
Practice Address - City:BRAZIL
Practice Address - State:IN
Practice Address - Zip Code:47834-7434
Practice Address - Country:US
Practice Address - Phone:812-448-8798
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-06
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN05003188A225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist