Provider Demographics
NPI:1265630222
Name:WEBSTER, SARAH (PT)
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:
Last Name:WEBSTER
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:SARAH
Other - Middle Name:
Other - Last Name:GOODMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:201 SMYTHE ST
Mailing Address - Street 2:#410
Mailing Address - City:GREENVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29611-3567
Mailing Address - Country:US
Mailing Address - Phone:610-806-6943
Mailing Address - Fax:
Practice Address - Street 1:1334 MILLER RD
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:SC
Practice Address - Zip Code:29607-5710
Practice Address - Country:US
Practice Address - Phone:864-234-5842
Practice Address - Fax:864-676-1468
Is Sole Proprietor?:No
Enumeration Date:2007-07-10
Last Update Date:2023-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC5508225100000X
TN8862225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist