Provider Demographics
NPI:1407305592
Name:DORNAN, SARAH A (PTA)
Entity Type:Individual
Prefix:MRS
First Name:SARAH
Middle Name:A
Last Name:DORNAN
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 1:201 S ROGERS RD
Mailing Address - Street 2:APARTMENT I 138
Mailing Address - City:HOT SPRINGS
Mailing Address - State:AR
Mailing Address - Zip Code:71913-6154
Mailing Address - Country:US
Mailing Address - Phone:318-347-1308
Mailing Address - Fax:
Practice Address - Street 1:201 S ROGERS RD
Practice Address - Street 2:APARTMENT I 138
Practice Address - City:HOT SPRINGS
Practice Address - State:AR
Practice Address - Zip Code:71913-6154
Practice Address - Country:US
Practice Address - Phone:318-347-1308
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-09-29
Last Update Date:2016-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR4082225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant