Provider Demographics
NPI:1265730758
Name:WOODBURY, SANDRA (RMT)
Entity type:Individual
Prefix:MS
First Name:SANDRA
Middle Name:
Last Name:WOODBURY
Suffix:
Gender:F
Credentials:RMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3955 E EXPOSITION AVE
Mailing Address - Street 2:#320
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80209-5000
Mailing Address - Country:US
Mailing Address - Phone:303-777-1151
Mailing Address - Fax:303-777-3112
Practice Address - Street 1:3955 E EXPOSITION AVE
Practice Address - Street 2:#320
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80209-5000
Practice Address - Country:US
Practice Address - Phone:303-777-1151
Practice Address - Fax:303-777-3112
Is Sole Proprietor?:No
Enumeration Date:2011-03-07
Last Update Date:2011-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO906174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist