Provider Demographics
NPI:1821028085
Name:VORP, SANDRA ELIZABETH (PTA)
Entity Type:Individual
Prefix:
First Name:SANDRA
Middle Name:ELIZABETH
Last Name:VORP
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:ATLANTIC PHYSICAL THERAPY & REHABILITATION, INC
Mailing Address - Street 2:3650 COALITION DRIVE
Mailing Address - City:MYRTLE BEACH
Mailing Address - State:SC
Mailing Address - Zip Code:29577
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:ATLANTIC PHYSICAL THERAPY & REHABILITATION, INC
Practice Address - Street 2:3650 COALITION DRIVE
Practice Address - City:MYRTLE BEACH
Practice Address - State:SC
Practice Address - Zip Code:29577
Practice Address - Country:US
Practice Address - Phone:843-293-7713
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC543225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant