Individual
SANDRA RAY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
719 S ROGERS ST, BLOOMINGTON, IN 47403-2335
(812) 323-4475
(812) 323-4478
Mailing address
550 S LANDMARK AVE, BLOOMINGTON, IN 47403-3239
(812) 323-4475
(812) 323-4478
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
05006736A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200488010
—
IN
Enumeration date
07/01/2005
Last updated
09/26/2008
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