Provider Demographics
NPI:1467684746
Name:SPRAU, STERLING T III (MSPT)
Entity Type:Individual
Prefix:MR
First Name:STERLING
Middle Name:T
Last Name:SPRAU
Suffix:III
Gender:M
Credentials:MSPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1274 BLYTHEBURN RD
Mailing Address - Street 2:
Mailing Address - City:MOUNTAIN TOP
Mailing Address - State:PA
Mailing Address - Zip Code:18707-9014
Mailing Address - Country:US
Mailing Address - Phone:570-868-0435
Mailing Address - Fax:
Practice Address - Street 1:1274 BLYTHEBURN RD
Practice Address - Street 2:
Practice Address - City:MOUNTAIN TOP
Practice Address - State:PA
Practice Address - Zip Code:18707-9014
Practice Address - Country:US
Practice Address - Phone:570-868-0435
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-08-20
Last Update Date:2009-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEJ1-0002497225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist