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Organization
SANDER PHYSICAL THERAPY LTD.
Active
Organization
SANDER PHYSICAL THERAPY LTD.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MISS DARCY D MYERS DPT (PRESIDENT)
(928) 771-8156
Entity
Organization
Contact information
Practice address
3195 STILLWATER AVE., STE. A, PRESCOTT, AZ 86305
(928) 771-8156
(928) 771-9519
Mailing address
PO BOX 10548, PRESCOTT, AZ 86304-0548
(928) 771-8156
(928) 771-9519
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
5331
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
099382
AHCCCS GROUP BILLING #
AZ
01
—
564973
AHCCCS INDIVIDUAL #
AZ
01
—
AZ0409500
BLUE CROSS BLUE SHIELD #
AZ
Enumeration date
05/18/2006
Last updated
08/22/2020
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