Provider Demographics
NPI:1952500985
Name:PREUSS, SANDRA FAYE (PTA)
Entity Type:Individual
Prefix:MRS
First Name:SANDRA
Middle Name:FAYE
Last Name:PREUSS
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 1:512 CHICAGO AVE
Mailing Address - Street 2:
Mailing Address - City:STUTTGART
Mailing Address - State:KS
Mailing Address - Zip Code:67661-9553
Mailing Address - Country:US
Mailing Address - Phone:785-543-5525
Mailing Address - Fax:785-543-5220
Practice Address - Street 1:512 CHICAGO AVE
Practice Address - Street 2:
Practice Address - City:STUTTGART
Practice Address - State:KS
Practice Address - Zip Code:67661-9553
Practice Address - Country:US
Practice Address - Phone:785-543-5525
Practice Address - Fax:785-543-5220
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-11
Last Update Date:2007-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS14-00473225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant