Provider Demographics
NPI:1356692537
Name:MOLONEY, SANDRA CHRISTIE (PT)
Entity type:Individual
Prefix:MRS
First Name:SANDRA
Middle Name:CHRISTIE
Last Name:MOLONEY
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:13825 W BURLEIGH RD
Mailing Address - Street 2:
Mailing Address - City:BROOKFIELD
Mailing Address - State:WI
Mailing Address - Zip Code:53005-3058
Mailing Address - Country:US
Mailing Address - Phone:262-754-3450
Mailing Address - Fax:262-754-3451
Practice Address - Street 1:600 N BARKER RD
Practice Address - Street 2:
Practice Address - City:BROOKFIELD
Practice Address - State:WI
Practice Address - Zip Code:53045-5919
Practice Address - Country:US
Practice Address - Phone:262-432-3027
Practice Address - Fax:262-797-0730
Is Sole Proprietor?:No
Enumeration Date:2012-09-27
Last Update Date:2012-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI9657-24225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist