Provider Demographics
NPI:1053528588
Name:NEWTON, SAUNDRA L (PT)
Entity type:Individual
Prefix:MRS
First Name:SAUNDRA
Middle Name:L
Last Name:NEWTON
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4917 DIXIE HWY STE M
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40216-2565
Mailing Address - Country:US
Mailing Address - Phone:502-449-0333
Mailing Address - Fax:502-449-7167
Practice Address - Street 1:4917 DIXIE HWY STE M
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40216-2565
Practice Address - Country:US
Practice Address - Phone:502-449-0333
Practice Address - Fax:502-449-7167
Is Sole Proprietor?:No
Enumeration Date:2007-05-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY002653225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY0645401Medicare ID - Type UnspecifiedMEDICARE PROVIDER ID