Provider Demographics
NPI:1407348402
Name:WALKER, SARA VICTORIA (DPT)
Entity Type:Individual
Prefix:
First Name:SARA
Middle Name:VICTORIA
Last Name:WALKER
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:SARA
Other - Middle Name:VICTORIA
Other - Last Name:VANDE RYT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DPT
Mailing Address - Street 1:7560 GARDNER PARK DR
Mailing Address - Street 2:
Mailing Address - City:GAINESVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:20155-3414
Mailing Address - Country:US
Mailing Address - Phone:703-753-1005
Mailing Address - Fax:703-753-2207
Practice Address - Street 1:7560 GARDNER PARK DR
Practice Address - Street 2:
Practice Address - City:GAINESVILLE
Practice Address - State:VA
Practice Address - Zip Code:20155-3414
Practice Address - Country:US
Practice Address - Phone:703-753-1005
Practice Address - Fax:703-753-2207
Is Sole Proprietor?:No
Enumeration Date:2018-06-05
Last Update Date:2018-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2305211490225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist