Individual
SANDRA ANN RAYBURN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
O.T.
Contact information
Practice address
980 CREEKVIEW DR STE B, COLUMBUS, IN 47201-6600
(812) 372-7023
(812) 372-7027
Mailing address
980 CREEKVIEW DR STE B, COLUMBUS, IN 47201-6600
(812) 372-7023
(812) 372-7027
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
31004269A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000519858
ANTHEM PROVIDER ID NUMBER
IN
Enumeration date
06/26/2007
Last updated
07/08/2007
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