Provider Demographics
NPI:1669762274
Name:CORMIER, SANDY L (ATP, CRTS)
Entity type:Individual
Prefix:MRS
First Name:SANDY
Middle Name:L
Last Name:CORMIER
Suffix:
Gender:F
Credentials:ATP, CRTS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8666 HUEBNER RD
Mailing Address - Street 2:#200
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78240-1844
Mailing Address - Country:US
Mailing Address - Phone:210-696-1084
Mailing Address - Fax:210-579-1551
Practice Address - Street 1:8666 HUEBNER RD
Practice Address - Street 2:#200
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78240-1844
Practice Address - Country:US
Practice Address - Phone:210-696-1084
Practice Address - Fax:210-579-1551
Is Sole Proprietor?:No
Enumeration Date:2011-04-15
Last Update Date:2011-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes247200000XTechnologists, Technicians & Other Technical Service ProvidersTechnician, Other