Provider Demographics
NPI:1386213841
Name:HUFFMAN, SARA ANN (PTA)
Entity Type:Individual
Prefix:
First Name:SARA
Middle Name:ANN
Last Name:HUFFMAN
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
Other - First Name:SARA
Other - Middle Name:ANN
Other - Last Name:CORRAL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1521 BRIDFORD PKWY # PRKW14F
Mailing Address - Street 2:
Mailing Address - City:GREENSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27407-2503
Mailing Address - Country:US
Mailing Address - Phone:336-420-6860
Mailing Address - Fax:
Practice Address - Street 1:801 MEADOWOOD ST
Practice Address - Street 2:
Practice Address - City:GREENSBORO
Practice Address - State:NC
Practice Address - Zip Code:27409-2838
Practice Address - Country:US
Practice Address - Phone:336-299-4400
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-06-21
Last Update Date:2021-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCA7454225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant