Provider Demographics
NPI:1467742361
Name:JENNINGS, SARAH MITCHELL (RPT)
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:MITCHELL
Last Name:JENNINGS
Suffix:
Gender:F
Credentials:RPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2807 GREYSTONE COMMERCIAL BLVD
Mailing Address - Street 2:SUITE 32
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35242-9600
Mailing Address - Country:US
Mailing Address - Phone:205-745-3650
Mailing Address - Fax:
Practice Address - Street 1:2807 GREYSTONE COMMERCIAL BLVD
Practice Address - Street 2:SUITE 32
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35242-9600
Practice Address - Country:US
Practice Address - Phone:205-745-3650
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-04-12
Last Update Date:2011-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALPTH582225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist