Provider Demographics
NPI:1205134434
Name:SIGUR, SANDRA L (REFLEXOLOGIST, LMT)
Entity type:Individual
Prefix:
First Name:SANDRA
Middle Name:L
Last Name:SIGUR
Suffix:
Gender:F
Credentials:REFLEXOLOGIST, LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1530 CELEBRATION BLVD
Mailing Address - Street 2:SUITE 412
Mailing Address - City:CELEBRATION
Mailing Address - State:FL
Mailing Address - Zip Code:34747-5164
Mailing Address - Country:US
Mailing Address - Phone:407-924-1401
Mailing Address - Fax:
Practice Address - Street 1:1009 WIREGRASS ST
Practice Address - Street 2:
Practice Address - City:CELEBRATION
Practice Address - State:FL
Practice Address - Zip Code:34747-4221
Practice Address - Country:US
Practice Address - Phone:407-924-1401
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-03-12
Last Update Date:2011-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL27630173C00000X
FLMA 42136225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes173C00000XOther Service ProvidersReflexologist
No225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist