Provider Demographics
NPI:1043624257
Name:AYOTTE, SARAH
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:
Last Name:AYOTTE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:SARAH
Other - Middle Name:
Other - Last Name:STUART
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 30516
Mailing Address - Street 2:DEPT 5300
Mailing Address - City:LANSING
Mailing Address - State:MI
Mailing Address - Zip Code:48909
Mailing Address - Country:US
Mailing Address - Phone:616-949-7310
Mailing Address - Fax:
Practice Address - Street 1:1621 44TH ST SW
Practice Address - Street 2:SUITE 300
Practice Address - City:WYOMING
Practice Address - State:MI
Practice Address - Zip Code:49509
Practice Address - Country:US
Practice Address - Phone:616-949-3538
Practice Address - Fax:616-840-9697
Is Sole Proprietor?:No
Enumeration Date:2014-06-16
Last Update Date:2022-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5501016441225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist