Individual
MS. SASHA LAUREL KOLBECK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MPT
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
3702
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
299303
—
OR
01
—
930635514
GROUP TAX NUMBER
OR
01
—
R0000WFBTV
MEDICARE GROUP PIN NUMBER
OR
Enumeration date
02/06/2006
Last updated
04/24/2013
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