Provider Demographics
NPI:1023215738
Name:HAZEL, SARAH MICHELLE (PTA)
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:MICHELLE
Last Name:HAZEL
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 1:3031 CHESTNUT HILL RD
Mailing Address - Street 2:
Mailing Address - City:POTTSTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:19465-8560
Mailing Address - Country:US
Mailing Address - Phone:610-469-6228
Mailing Address - Fax:610-469-1220
Practice Address - Street 1:3031 CHESTNUT HILL RD
Practice Address - Street 2:
Practice Address - City:POTTSTOWN
Practice Address - State:PA
Practice Address - Zip Code:19465-8560
Practice Address - Country:US
Practice Address - Phone:610-469-6228
Practice Address - Fax:610-469-1220
Is Sole Proprietor?:No
Enumeration Date:2007-06-27
Last Update Date:2009-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PATEI001773225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant