Provider Demographics
NPI:1417127010
Name:MOATS, SARAH BEIDLER (DPT)
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:BEIDLER
Last Name:MOATS
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 1:1420 W BADDOUR PKWY
Mailing Address - Street 2:120
Mailing Address - City:LEBANON
Mailing Address - State:TN
Mailing Address - Zip Code:37087-1510
Mailing Address - Country:US
Mailing Address - Phone:615-443-9036
Mailing Address - Fax:615-443-9037
Practice Address - Street 1:1420 W BADDOUR PKWY
Practice Address - Street 2:120
Practice Address - City:LEBANON
Practice Address - State:TN
Practice Address - Zip Code:37087-1510
Practice Address - Country:US
Practice Address - Phone:615-443-9036
Practice Address - Fax:615-443-9037
Is Sole Proprietor?:No
Enumeration Date:2008-03-10
Last Update Date:2008-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN8039225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist