Provider Demographics
NPI:1386215515
Name:GAMILLO, SARAH (DPT)
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:
Last Name:GAMILLO
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 1:5135 S RIVER RUN DR
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85746-2005
Mailing Address - Country:US
Mailing Address - Phone:715-316-1167
Mailing Address - Fax:
Practice Address - Street 1:1991 E AJO WAY STE 149
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85713-6269
Practice Address - Country:US
Practice Address - Phone:520-325-4002
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-07-08
Last Update Date:2021-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZLPT-31848225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist