Provider Demographics
NPI:1437400652
Name:TALBOT, SARA E (DPT)
Entity Type:Individual
Prefix:
First Name:SARA
Middle Name:E
Last Name:TALBOT
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 1:3160 CENTRAL PARK W
Mailing Address - Street 2:
Mailing Address - City:TOLEDO
Mailing Address - State:OH
Mailing Address - Zip Code:43617-1083
Mailing Address - Country:US
Mailing Address - Phone:419-841-1840
Mailing Address - Fax:419-841-1841
Practice Address - Street 1:3160 CENTRAL PARK W
Practice Address - Street 2:
Practice Address - City:TOLEDO
Practice Address - State:OH
Practice Address - Zip Code:43617-1083
Practice Address - Country:US
Practice Address - Phone:419-841-1840
Practice Address - Fax:419-841-1841
Is Sole Proprietor?:No
Enumeration Date:2012-09-27
Last Update Date:2019-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPT602768752251G0304X, 225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
No2251G0304XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGeriatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA225100000XMedicaid