Provider Demographics
NPI:1295191963
Name:PAUL, SARAH JEAN (ATC)
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:JEAN
Last Name:PAUL
Suffix:
Gender:F
Credentials:ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3918 W 14TH STREET RD
Mailing Address - Street 2:
Mailing Address - City:GREELEY
Mailing Address - State:CO
Mailing Address - Zip Code:80634-2718
Mailing Address - Country:US
Mailing Address - Phone:970-405-5912
Mailing Address - Fax:352-375-4805
Practice Address - Street 1:121 GALE LEMERAND DR
Practice Address - Street 2:SOUTH END ZONE ATHLETIC TRAINING ROOM
Practice Address - City:GAINESVILLE
Practice Address - State:FL
Practice Address - Zip Code:32611-2051
Practice Address - Country:US
Practice Address - Phone:970-405-5912
Practice Address - Fax:352-375-4805
Is Sole Proprietor?:Yes
Enumeration Date:2016-01-11
Last Update Date:2016-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAL 43262255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer