Provider Demographics
NPI:1326350331
Name:MANGIARELLI, SARAH KATHERINE (DPT)
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:KATHERINE
Last Name:MANGIARELLI
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5000 E MARKET ST
Mailing Address - Street 2:SUITE 4
Mailing Address - City:WARREN
Mailing Address - State:OH
Mailing Address - Zip Code:44484-2260
Mailing Address - Country:US
Mailing Address - Phone:330-393-0079
Mailing Address - Fax:330-393-0077
Practice Address - Street 1:5000 E MARKET ST
Practice Address - Street 2:SUITE 4
Practice Address - City:WARREN
Practice Address - State:OH
Practice Address - Zip Code:44484-2260
Practice Address - Country:US
Practice Address - Phone:330-393-0079
Practice Address - Fax:330-393-0077
Is Sole Proprietor?:Yes
Enumeration Date:2010-07-07
Last Update Date:2010-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH012906225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist