Provider Demographics
NPI:1134660012
Name:HIXON, SARAH (PT, DPT, SCS, ATC)
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:
Last Name:HIXON
Suffix:
Gender:F
Credentials:PT, DPT, SCS, ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2095 HILLSIDE RD UNIT 1173
Mailing Address - Street 2:
Mailing Address - City:STORRS
Mailing Address - State:CT
Mailing Address - Zip Code:06269-1173
Mailing Address - Country:US
Mailing Address - Phone:860-486-0055
Mailing Address - Fax:860-486-5277
Practice Address - Street 1:2095 HILLSIDE RD UNIT 1173
Practice Address - Street 2:
Practice Address - City:STORRS
Practice Address - State:CT
Practice Address - Zip Code:06269-1173
Practice Address - Country:US
Practice Address - Phone:860-486-0055
Practice Address - Fax:860-486-5277
Is Sole Proprietor?:Yes
Enumeration Date:2017-03-13
Last Update Date:2019-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCLAT-29072255A2300X
NCP16507225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
No2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer