Individual
TERESSA M SANDERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DPT
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PT2294
STATE OF IDAHO
ID
01
—
PT5044
STATE OF MISSISSIPPI
MS
01
—
PTL-8875
LICENSE #
CO
Enumeration date
08/29/2006
Last updated
08/19/2018
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