Provider Demographics
NPI:1134359680
Name:SANDMAN, DENISE M (PT)
Entity type:Individual
Prefix:
First Name:DENISE
Middle Name:M
Last Name:SANDMAN
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 1:290 HERITAGE RD
Mailing Address - Street 2:
Mailing Address - City:VERSAILLES
Mailing Address - State:KY
Mailing Address - Zip Code:40383-9287
Mailing Address - Country:US
Mailing Address - Phone:859-879-8067
Mailing Address - Fax:877-212-2525
Practice Address - Street 1:3520 SAMPLE WAY
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40245-7410
Practice Address - Country:US
Practice Address - Phone:502-550-2525
Practice Address - Fax:877-212-2525
Is Sole Proprietor?:No
Enumeration Date:2009-07-17
Last Update Date:2009-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY001413225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist