Provider Demographics
NPI:1447497797
Name:SANCHEZ, MARTY J (DPT)
Entity type:Individual
Prefix:
First Name:MARTY
Middle Name:J
Last Name:SANCHEZ
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3801 LAKE OTIS PKWY
Mailing Address - Street 2:SUITE 300
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99508-5234
Mailing Address - Country:US
Mailing Address - Phone:907-562-2277
Mailing Address - Fax:907-563-3460
Practice Address - Street 1:3801 LAKE OTIS PKWY
Practice Address - Street 2:SUITE 300
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99508-5234
Practice Address - Country:US
Practice Address - Phone:907-562-2277
Practice Address - Fax:907-563-3460
Is Sole Proprietor?:No
Enumeration Date:2009-01-08
Last Update Date:2016-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AKPHYP24472251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic
Provider Identifiers
StateIdentifier IDID TypeIssuer
AK1630515Medicaid
AKK167063Medicare PIN