Provider Demographics
NPI:1154684793
Name:SARTIN, EDWARD NELSON (PTA)
Entity Type:Individual
Prefix:
First Name:EDWARD
Middle Name:NELSON
Last Name:SARTIN
Suffix:
Gender:M
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2525 BOOKER CREEK RD
Mailing Address - Street 2:B17
Mailing Address - City:CHAPEL HILL
Mailing Address - State:NC
Mailing Address - Zip Code:27514-5100
Mailing Address - Country:US
Mailing Address - Phone:919-561-0949
Mailing Address - Fax:
Practice Address - Street 1:2059 TORREDGE RD
Practice Address - Street 2:
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27712-1767
Practice Address - Country:US
Practice Address - Phone:919-477-4474
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-06-19
Last Update Date:2012-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCA4526225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant