Provider Demographics
NPI:1669600763
Name:MONTMINY, SANDRA L (DPT)
Entity type:Individual
Prefix:
First Name:SANDRA
Middle Name:L
Last Name:MONTMINY
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:SANDRA
Other - Middle Name:L
Other - Last Name:ROBINSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DPT
Mailing Address - Street 1:1 GREENLEAF WOODS DR
Mailing Address - Street 2:SUITE #101
Mailing Address - City:PORTSMOUTH
Mailing Address - State:NH
Mailing Address - Zip Code:03801-5437
Mailing Address - Country:US
Mailing Address - Phone:603-319-8334
Mailing Address - Fax:
Practice Address - Street 1:1 GREENLEAF WOODS DR
Practice Address - Street 2:SUITE #101
Practice Address - City:PORTSMOUTH
Practice Address - State:NH
Practice Address - Zip Code:03801-5437
Practice Address - Country:US
Practice Address - Phone:603-319-8334
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-06-26
Last Update Date:2014-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA18567225100000X
NH3777225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist