Provider Demographics
NPI:1265596316
Name:WINDTBERG, SANDRA JEAN (PT)
Entity type:Individual
Prefix:MRS
First Name:SANDRA
Middle Name:JEAN
Last Name:WINDTBERG
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 1:1514 E WESTCHESTER DR
Mailing Address - Street 2:
Mailing Address - City:TEMPE
Mailing Address - State:AZ
Mailing Address - Zip Code:85283-3152
Mailing Address - Country:US
Mailing Address - Phone:480-839-3309
Mailing Address - Fax:
Practice Address - Street 1:1514 E WESTCHESTER DR
Practice Address - Street 2:
Practice Address - City:TEMPE
Practice Address - State:AZ
Practice Address - Zip Code:85283-3152
Practice Address - Country:US
Practice Address - Phone:480-839-3309
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-12-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ385225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist