Provider Demographics
NPI:1881619906
Name:SASSER, ERIC DAVID (PT)
Entity type:Individual
Prefix:MR
First Name:ERIC
Middle Name:DAVID
Last Name:SASSER
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3830 N GRIMES ST
Mailing Address - Street 2:SUITE B
Mailing Address - City:HOBBS
Mailing Address - State:NM
Mailing Address - Zip Code:88240-1279
Mailing Address - Country:US
Mailing Address - Phone:575-392-3971
Mailing Address - Fax:
Practice Address - Street 1:3830 N. GRIMES
Practice Address - Street 2:SUITE B
Practice Address - City:HOBBS
Practice Address - State:NM
Practice Address - Zip Code:88240
Practice Address - Country:US
Practice Address - Phone:575-392-3971
Practice Address - Fax:575-392-4169
Is Sole Proprietor?:No
Enumeration Date:2006-07-12
Last Update Date:2012-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM3260225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist