Individual
CARL ANDREW SANDSTROM
Active
Individual
CARL ANDREW SANDSTROM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MSPT
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
DAPT000113
PA
225100000X
Physical Therapist
Primary
PT007634L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1028776920001
—
PA
Enumeration date
12/20/2005
Last updated
06/20/2024
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