Provider Demographics
NPI:1407599913
Name:ANDERSON, SARAH MARIE (PHYSICAL THERAPIST)
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:MARIE
Last Name:ANDERSON
Suffix:
Gender:F
Credentials:PHYSICAL THERAPIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1187 N WILLOW AVE STE 103
Mailing Address - Street 2:
Mailing Address - City:CLOVIS
Mailing Address - State:CA
Mailing Address - Zip Code:93611-4411
Mailing Address - Country:US
Mailing Address - Phone:559-283-2221
Mailing Address - Fax:
Practice Address - Street 1:2026 CHENNAULT AVE
Practice Address - Street 2:
Practice Address - City:CLOVIS
Practice Address - State:CA
Practice Address - Zip Code:93611-6887
Practice Address - Country:US
Practice Address - Phone:559-283-2221
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-04-14
Last Update Date:2022-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA33383261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy