Provider Demographics
NPI:1851563449
Name:WHEELER, SANDRA NORRIS (LMT)
Entity Type:Individual
Prefix:MS
First Name:SANDRA
Middle Name:NORRIS
Last Name:WHEELER
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1972 ALDER ST
Mailing Address - Street 2:
Mailing Address - City:EUGENE
Mailing Address - State:OR
Mailing Address - Zip Code:97405-2938
Mailing Address - Country:US
Mailing Address - Phone:541-343-4415
Mailing Address - Fax:541-343-3157
Practice Address - Street 1:1972 ALDER ST
Practice Address - Street 2:
Practice Address - City:EUGENE
Practice Address - State:OR
Practice Address - Zip Code:97405-2938
Practice Address - Country:US
Practice Address - Phone:541-343-4415
Practice Address - Fax:541-343-3157
Is Sole Proprietor?:Yes
Enumeration Date:2008-03-24
Last Update Date:2008-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR1610225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist