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Individual

CARL ANDREW SANDSTROM

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MSPT

Contact information

Practice address
2265 MARKET ST, SUITE A, WARREN, PA 16365-4625
(814) 726-9050
(814) 726-9629
Mailing address
2265 MARKET ST STE A, WARREN, PA 16365-4682
(814) 726-9050
(814) 726-9629

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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