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Individual
MR. THOMAS RICHARD SANDERSON
Active
Individual
MR. THOMAS RICHARD SANDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PRT1364
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
AZ0460450
BCBS
AZ
Enumeration date
10/24/2005
Last updated
07/08/2007
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