Provider Demographics
NPI:1093125098
Name:DUNBAR, SARA ALICE BURNHAM (ATC, RN, EMT)
Entity Type:Individual
Prefix:
First Name:SARA
Middle Name:ALICE BURNHAM
Last Name:DUNBAR
Suffix:
Gender:F
Credentials:ATC, RN, EMT
Other - Prefix:
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Mailing Address - Street 1:PO BOX 500
Mailing Address - Street 2:
Mailing Address - City:SAXTONS RIVER
Mailing Address - State:VT
Mailing Address - Zip Code:05154-0500
Mailing Address - Country:US
Mailing Address - Phone:802-869-6237
Mailing Address - Fax:802-869-6608
Practice Address - Street 1:10 LONG WALK
Practice Address - Street 2:
Practice Address - City:SAXTONS RIVER
Practice Address - State:VT
Practice Address - Zip Code:05154-4500
Practice Address - Country:US
Practice Address - Phone:802-869-6237
Practice Address - Fax:802-869-6608
Is Sole Proprietor?:Yes
Enumeration Date:2014-04-30
Last Update Date:2014-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT104.00000652255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer