Provider Demographics
NPI:1457012916
Name:GILLISSE, SARAH ANNE (DPT)
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:ANNE
Last Name:GILLISSE
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:SARAH
Other - Middle Name:
Other - Last Name:ZIGARELLI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:126 W HARRISBURG ST STE A
Mailing Address - Street 2:
Mailing Address - City:DILLSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17019-1273
Mailing Address - Country:US
Mailing Address - Phone:717-502-7318
Mailing Address - Fax:717-502-7582
Practice Address - Street 1:126 W HARRISBURG ST STE A
Practice Address - Street 2:
Practice Address - City:DILLSBURG
Practice Address - State:PA
Practice Address - Zip Code:17019-1273
Practice Address - Country:US
Practice Address - Phone:717-502-7318
Practice Address - Fax:717-502-7582
Is Sole Proprietor?:Yes
Enumeration Date:2022-01-06
Last Update Date:2024-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT030261225100000X, 225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty