Provider Demographics
NPI:1437539293
Name:DAVIDSON, SARA ANNE M (DPT)
Entity Type:Individual
Prefix:
First Name:SARA ANNE
Middle Name:M
Last Name:DAVIDSON
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 1:2725 JAMES SANDERS BLVD
Mailing Address - Street 2:STE B
Mailing Address - City:PADUCAH
Mailing Address - State:KY
Mailing Address - Zip Code:42001-8405
Mailing Address - Country:US
Mailing Address - Phone:615-465-0922
Mailing Address - Fax:615-221-9054
Practice Address - Street 1:1605 WESTGATE CIR
Practice Address - Street 2:
Practice Address - City:BRENTWOOD
Practice Address - State:TN
Practice Address - Zip Code:37027-8395
Practice Address - Country:US
Practice Address - Phone:615-849-9358
Practice Address - Fax:615-849-9360
Is Sole Proprietor?:No
Enumeration Date:2015-06-05
Last Update Date:2018-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN10459225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist