Provider Demographics
NPI:1467856526
Name:BEVERS, SARAH (LAT, ATC)
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:
Last Name:BEVERS
Suffix:
Gender:F
Credentials:LAT, ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11201 N COUNTY ROAD 675 W
Mailing Address - Street 2:
Mailing Address - City:MONROVIA
Mailing Address - State:IN
Mailing Address - Zip Code:46157-9200
Mailing Address - Country:US
Mailing Address - Phone:317-430-8585
Mailing Address - Fax:
Practice Address - Street 1:11201 N COUNTY ROAD 675 W
Practice Address - Street 2:
Practice Address - City:MONROVIA
Practice Address - State:IN
Practice Address - Zip Code:46157-9200
Practice Address - Country:US
Practice Address - Phone:317-430-8585
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-10-18
Last Update Date:2014-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN36002001A2255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer