Provider Demographics
NPI:1043608953
Name:SARTE, MA RAQUEL HONEYLET
Entity Type:Individual
Prefix:
First Name:MA RAQUEL HONEYLET
Middle Name:
Last Name:SARTE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 HAMILTON POINTE DR.
Mailing Address - Street 2:115
Mailing Address - City:BYRON
Mailing Address - State:GA
Mailing Address - Zip Code:31008
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:100 HAMILTON POINTE DRIVE
Practice Address - Street 2:115
Practice Address - City:BYRON
Practice Address - State:GA
Practice Address - Zip Code:31008
Practice Address - Country:US
Practice Address - Phone:478-956-4916
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-12-30
Last Update Date:2014-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAPT010524225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist