Provider Demographics
NPI:1306221080
Name:ROBERTSON, SARA JOYCE (DPT)
Entity Type:Individual
Prefix:
First Name:SARA
Middle Name:JOYCE
Last Name:ROBERTSON
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:SARA
Other - Middle Name:JOYCE
Other - Last Name:PALMER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DPT
Mailing Address - Street 1:3500 FAIRVIEW ST. LEGACY HEALTHCARE SERVICES
Mailing Address - Street 2:
Mailing Address - City:BETHLEHEM
Mailing Address - State:PA
Mailing Address - Zip Code:18017
Mailing Address - Country:US
Mailing Address - Phone:610-419-4092
Mailing Address - Fax:610-419-4098
Practice Address - Street 1:3500 FAIRVIEW ST.
Practice Address - Street 2:
Practice Address - City:BETHLEHEM
Practice Address - State:PA
Practice Address - Zip Code:18017
Practice Address - Country:US
Practice Address - Phone:610-419-4092
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-07-23
Last Update Date:2020-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT024458225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist