Provider Demographics
NPI:1437793213
Name:ROBERTSON, SARAH (PTA)
Entity Type:Individual
Prefix:MRS
First Name:SARAH
Middle Name:
Last Name:ROBERTSON
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15 CLUB HOUSE DR
Mailing Address - Street 2:
Mailing Address - City:SAVANNAH
Mailing Address - State:GA
Mailing Address - Zip Code:31419-8381
Mailing Address - Country:US
Mailing Address - Phone:804-920-5573
Mailing Address - Fax:
Practice Address - Street 1:22 PLANTATION PARK DR STE 105B
Practice Address - Street 2:
Practice Address - City:BLUFFTON
Practice Address - State:SC
Practice Address - Zip Code:29910-9046
Practice Address - Country:US
Practice Address - Phone:843-705-8230
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-11-04
Last Update Date:2019-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC3815225200000X
GA003681225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant