Provider Demographics
NPI:1194227835
Name:DAVIS, SARAH KATHLEEN (PT, DPT, MS, ATC)
Entity Type:Individual
Prefix:DR
First Name:SARAH
Middle Name:KATHLEEN
Last Name:DAVIS
Suffix:
Gender:F
Credentials:PT, DPT, MS, ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:30 VALMOORE DR
Mailing Address - Street 2:
Mailing Address - City:POQUOSON
Mailing Address - State:VA
Mailing Address - Zip Code:23662-1244
Mailing Address - Country:US
Mailing Address - Phone:757-504-8181
Mailing Address - Fax:
Practice Address - Street 1:30 VALMOORE DR
Practice Address - Street 2:
Practice Address - City:POQUOSON
Practice Address - State:VA
Practice Address - Zip Code:23662-1244
Practice Address - Country:US
Practice Address - Phone:757-504-8181
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-03-07
Last Update Date:2022-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEJ3-00007832255A2300X
DEJ1-0014481225100000X
225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
No2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer