Provider Demographics
NPI:1467646737
Name:BOSWORTH, SARAH JEAN-TAYLOR (DPT)
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:JEAN-TAYLOR
Last Name:BOSWORTH
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 1:504 BLOSSOM DR
Mailing Address - Street 2:
Mailing Address - City:BERRYVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:22611-1196
Mailing Address - Country:US
Mailing Address - Phone:540-327-6162
Mailing Address - Fax:
Practice Address - Street 1:3150 SHAWNEE DR
Practice Address - Street 2:
Practice Address - City:WINCHESTER
Practice Address - State:VA
Practice Address - Zip Code:22601-4208
Practice Address - Country:US
Practice Address - Phone:540-450-1052
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-08-30
Last Update Date:2023-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2305205178225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist