Provider Demographics
NPI:1174956346
Name:SASSAMAN, PATRICIA JEAN (LMT)
Entity type:Individual
Prefix:
First Name:PATRICIA
Middle Name:JEAN
Last Name:SASSAMAN
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:164 E SECOND STREET
Mailing Address - Street 2:
Mailing Address - City:LANSDALE
Mailing Address - State:PA
Mailing Address - Zip Code:19446-2528
Mailing Address - Country:US
Mailing Address - Phone:267-446-8238
Mailing Address - Fax:
Practice Address - Street 1:507 W GERMANTOWN PIKE
Practice Address - Street 2:
Practice Address - City:EAST NORRITON
Practice Address - State:PA
Practice Address - Zip Code:19403-4231
Practice Address - Country:US
Practice Address - Phone:610-275-3355
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-08-12
Last Update Date:2013-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMSG006628225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist