Provider Demographics
NPI:1043546955
Name:NASHOLD, SARAH (LMT,CKTP,NCTMB)
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:
Last Name:NASHOLD
Suffix:
Gender:F
Credentials:LMT,CKTP,NCTMB
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:87 E 4TH AVE APT A
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43201-3552
Mailing Address - Country:US
Mailing Address - Phone:773-895-2823
Mailing Address - Fax:
Practice Address - Street 1:87 E 4TH AVE APT A
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43201-3552
Practice Address - Country:US
Practice Address - Phone:773-895-2823
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-10-27
Last Update Date:2009-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH33.017739N-R172M00000X
OH569084-08172M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172M00000XOther Service ProvidersMechanotherapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH$$$$$$$$$00OtherBUREAU OF WORKMAN'S COMP