Provider Demographics
NPI:1841829934
Name:SANCHEZ, ERICA (PTA)
Entity type:Individual
Prefix:MRS
First Name:ERICA
Middle Name:
Last Name:SANCHEZ
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4131 W LOOMIS RD STE 200
Mailing Address - Street 2:
Mailing Address - City:GREENFIELD
Mailing Address - State:WI
Mailing Address - Zip Code:53221-2041
Mailing Address - Country:US
Mailing Address - Phone:414-698-5058
Mailing Address - Fax:
Practice Address - Street 1:4131 W LOOMIS RD STE 200
Practice Address - Street 2:
Practice Address - City:GREENFIELD
Practice Address - State:WI
Practice Address - Zip Code:53221-2041
Practice Address - Country:US
Practice Address - Phone:414-698-5058
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-04-02
Last Update Date:2020-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI1241-19225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant