Provider Demographics
NPI:1093399818
Name:MILOT, SARAH KELLER
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:KELLER
Last Name:MILOT
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 1:4006 LOUISIANA ST APT 4
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92104-2487
Mailing Address - Country:US
Mailing Address - Phone:508-821-0899
Mailing Address - Fax:
Practice Address - Street 1:12515 SPRINGHURST DR
Practice Address - Street 2:
Practice Address - City:POWAY
Practice Address - State:CA
Practice Address - Zip Code:99206
Practice Address - Country:US
Practice Address - Phone:858-391-9160
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-05-07
Last Update Date:2021-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA299872225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist