Provider Demographics
NPI:1023204930
Name:STUMP, SARAH MICHELLE (PTA)
Entity Type:Individual
Prefix:MRS
First Name:SARAH
Middle Name:MICHELLE
Last Name:STUMP
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5230 LEATHERWOOD DR
Mailing Address - Street 2:
Mailing Address - City:WEST CHESTER
Mailing Address - State:OH
Mailing Address - Zip Code:45069-1874
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:8650 GOVERNORS HILL DR
Practice Address - Street 2:SUITE 180
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45249-1372
Practice Address - Country:US
Practice Address - Phone:513-791-5766
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-09-25
Last Update Date:2007-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH06655225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant