Provider Demographics
NPI:1376257162
Name:SCHENSTED, SARAH MARIE (PTA)
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:MARIE
Last Name:SCHENSTED
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3314 WEST AVE
Mailing Address - Street 2:
Mailing Address - City:GULF BREEZE
Mailing Address - State:FL
Mailing Address - Zip Code:32563-3348
Mailing Address - Country:US
Mailing Address - Phone:206-331-2779
Mailing Address - Fax:
Practice Address - Street 1:4410 GULF BREEZE PKWY FL 32563
Practice Address - Street 2:
Practice Address - City:GULF BREEZE
Practice Address - State:FL
Practice Address - Zip Code:32563-8130
Practice Address - Country:US
Practice Address - Phone:850-749-5215
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-01-06
Last Update Date:2023-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL30735225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant