Individual
SANDRA KAY MISHIC
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DPT
Contact information
Practice address
39 MIDWAY RD, KANE, PA 16735-4429
(814) 598-6422
(814) 837-6237
Mailing address
39 MIDWAY RD, KANE, PA 16735-4429
(814) 598-6422
(814) 837-6237
Taxonomy
Speciality
Code
Description
License number
State
2251P0200X
Pediatric Physical Therapist
Primary
PT013931L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1010755820002
—
PA
Enumeration date
02/23/2007
Last updated
07/09/2007
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