Provider Demographics
NPI:1477053122
Name:BORTHWICK, SARAH L (BOC- ATC)
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:L
Last Name:BORTHWICK
Suffix:
Gender:F
Credentials:BOC- ATC
Other - Prefix:MISS
Other - First Name:SARAH
Other - Middle Name:L
Other - Last Name:BORTHWICK
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:ATC
Mailing Address - Street 1:3753 ELMSIDE VILLAGE LN APT A
Mailing Address - Street 2:
Mailing Address - City:PEACHTREE CORNERS
Mailing Address - State:GA
Mailing Address - Zip Code:30092-4880
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3753 ELMSIDE VILLAGE LN APT A
Practice Address - Street 2:
Practice Address - City:PEACHTREE CORNERS
Practice Address - State:GA
Practice Address - Zip Code:30092-4880
Practice Address - Country:US
Practice Address - Phone:740-503-4158
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-02-20
Last Update Date:2018-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer