Provider Demographics
NPI:1841254836
Name:SANDERS, AMY BYARS (RPT)
Entity type:Individual
Prefix:MRS
First Name:AMY
Middle Name:BYARS
Last Name:SANDERS
Suffix:
Gender:F
Credentials:RPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:651 MAIN ST
Mailing Address - Street 2:SUITE 119
Mailing Address - City:GARDENDALE
Mailing Address - State:AL
Mailing Address - Zip Code:35071-2789
Mailing Address - Country:US
Mailing Address - Phone:205-608-3113
Mailing Address - Fax:205-608-3036
Practice Address - Street 1:651 MAIN ST
Practice Address - Street 2:SUITE 119
Practice Address - City:GARDENDALE
Practice Address - State:AL
Practice Address - Zip Code:35071-2789
Practice Address - Country:US
Practice Address - Phone:205-608-3113
Practice Address - Fax:205-608-3036
Is Sole Proprietor?:No
Enumeration Date:2006-04-14
Last Update Date:2012-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALPTH4281225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL515-33466OtherBLUE CROSS BLUE SHIELD
ALQ05576OtherMEDICARE UPIN
AL051533466BYAMedicare ID - Type UnspecifiedPROVIDER NUMBER
AL#60043Medicare UPIN