Provider Demographics
NPI:1255691374
Name:COLLEY, SARA JANE (PT, DPT, SCS)
Entity Type:Individual
Prefix:
First Name:SARA
Middle Name:JANE
Last Name:COLLEY
Suffix:
Gender:F
Credentials:PT, DPT, SCS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:148 E MAIN ST
Mailing Address - Street 2:
Mailing Address - City:CARNEGIE
Mailing Address - State:PA
Mailing Address - Zip Code:15106-2429
Mailing Address - Country:US
Mailing Address - Phone:412-726-1016
Mailing Address - Fax:412-276-1080
Practice Address - Street 1:148 E MAIN ST
Practice Address - Street 2:
Practice Address - City:CARNEGIE
Practice Address - State:PA
Practice Address - Zip Code:15106-2429
Practice Address - Country:US
Practice Address - Phone:412-276-1016
Practice Address - Fax:412-275-1080
Is Sole Proprietor?:No
Enumeration Date:2012-05-23
Last Update Date:2015-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PRPT021615225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist