Provider Demographics
NPI:1073189379
Name:SPRINGER, SIERRA (DPT)
Entity Type:Individual
Prefix:
First Name:SIERRA
Middle Name:
Last Name:SPRINGER
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:630 LEXINGTON AVE
Mailing Address - Street 2:
Mailing Address - City:MANSFIELD
Mailing Address - State:OH
Mailing Address - Zip Code:44907-1500
Mailing Address - Country:US
Mailing Address - Phone:419-756-0616
Mailing Address - Fax:
Practice Address - Street 1:630 LEXINGTON AVE
Practice Address - Street 2:
Practice Address - City:MANSFIELD
Practice Address - State:OH
Practice Address - Zip Code:44907-1500
Practice Address - Country:US
Practice Address - Phone:740-392-8811
Practice Address - Fax:740-392-6485
Is Sole Proprietor?:No
Enumeration Date:2021-05-28
Last Update Date:2022-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH019257225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist