Provider Demographics
NPI:1356765176
Name:SALATANDRE, HANNS REINHARD
Entity type:Individual
Prefix:MR
First Name:HANNS REINHARD
Middle Name:
Last Name:SALATANDRE
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1837 NEBRASKA AVE
Mailing Address - Street 2:
Mailing Address - City:GRANTS PASS
Mailing Address - State:OR
Mailing Address - Zip Code:97527-5701
Mailing Address - Country:US
Mailing Address - Phone:706-913-3408
Mailing Address - Fax:
Practice Address - Street 1:1837 NEBRASKA AVE
Practice Address - Street 2:
Practice Address - City:GRANTS PASS
Practice Address - State:OR
Practice Address - Zip Code:97527-5701
Practice Address - Country:US
Practice Address - Phone:706-913-3408
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-02-13
Last Update Date:2021-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR639362251P0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251P0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistPediatrics