Sandra Burnley Short, PTA

Individual provider Active NPI Physical Therapy Assistant · New Freedom, PA

NPI 1922590843 · NPPES record last updated Jun 6, 2018

Key facts

NPI
1922590843
Entity type
Individual (NPI type 1)
Primary specialty
Physical Therapy Assistant 225200000X
License
A4930 (MD)
Practice address
5 Otis CT
New Freedom, PA 17349-9755
Phone
(757) 291-4589
NPI assigned
Jun 6, 2018
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
A4930MDMDPhysical Therapy Assistant

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant
Group: 193400000X SINGLE SPECIALTY GROUP
225200000X A4930 MD Yes

Addresses

Primary practice location

5 Otis CT
New Freedom, PA 17349-9755

Mailing address

5 Otis CT
New Freedom, PA 17349-9755
Phone (757) 291-4589

Other names

  • Miss Sandra Lea Burnley Former name

Other providers in New Freedom, PA

All providers in New Freedom, PA · Physical Therapy Assistant in Pennsylvania

Sources for this page

Verify at the official NPI Registry.