Provider Demographics
NPI:1851530174
Name:SANCHEZ, LACINDA GAYETT (PHYSICAL THERAPIST)
Entity Type:Individual
Prefix:MRS
First Name:LACINDA
Middle Name:GAYETT
Last Name:SANCHEZ
Suffix:
Gender:F
Credentials:PHYSICAL THERAPIST
Other - Prefix:MRS
Other - First Name:LACINDA
Other - Middle Name:GAYETT
Other - Last Name:SMITH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT
Mailing Address - Street 1:RT 2
Mailing Address - Street 2:BOX 29C
Mailing Address - City:SNYDER
Mailing Address - State:OK
Mailing Address - Zip Code:73566
Mailing Address - Country:US
Mailing Address - Phone:580-351-4092
Mailing Address - Fax:
Practice Address - Street 1:16483 N. 2300 RD
Practice Address - Street 2:RT 2, BOX 29C
Practice Address - City:SNYDER
Practice Address - State:OK
Practice Address - Zip Code:73566
Practice Address - Country:US
Practice Address - Phone:580-351-4092
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-02-10
Last Update Date:2009-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK1534225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist