Provider Demographics
NPI:1033235197
Name:BUITRAGO, SARAH JANE (PTA)
Entity Type:Individual
Prefix:MS
First Name:SARAH
Middle Name:JANE
Last Name:BUITRAGO
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:MISS
Other - First Name:SARAH
Other - Middle Name:JANE
Other - Last Name:RITTERBUSCH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PTA
Mailing Address - Street 1:270 OAK BRANCH DR
Mailing Address - Street 2:
Mailing Address - City:SIMPSONVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29681-3256
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:414 SUMMIT DR
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:SC
Practice Address - Zip Code:29609-4821
Practice Address - Country:US
Practice Address - Phone:864-271-7562
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-21
Last Update Date:2019-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC2081225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant