Provider Demographics
NPI:1730409434
Name:SANDERS, BETTY JO (PT)
Entity type:Individual
Prefix:MRS
First Name:BETTY
Middle Name:JO
Last Name:SANDERS
Suffix:
Gender:F
Credentials:PT
Other - Prefix:MRS
Other - First Name:BJ
Other - Middle Name:
Other - Last Name:SANDERS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PT
Mailing Address - Street 1:3085 WESTMINISTER RD
Mailing Address - Street 2:
Mailing Address - City:LUMBERTON
Mailing Address - State:NC
Mailing Address - Zip Code:28360-9080
Mailing Address - Country:US
Mailing Address - Phone:910-827-2288
Mailing Address - Fax:
Practice Address - Street 1:410 CATON RD
Practice Address - Street 2:PUBLIC SCHOOLS OF ROBESON COUNTY
Practice Address - City:LUMBERTON
Practice Address - State:NC
Practice Address - Zip Code:28358
Practice Address - Country:US
Practice Address - Phone:910-735-2212
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-06-03
Last Update Date:2010-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC1677225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist