Provider Demographics
NPI:1477260628
Name:SHUEY, SARA (PT, DPT)
Entity Type:Individual
Prefix:
First Name:SARA
Middle Name:
Last Name:SHUEY
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:SARA
Other - Middle Name:
Other - Last Name:NELSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT, DPT
Mailing Address - Street 1:1155 W JULIA WAY
Mailing Address - Street 2:
Mailing Address - City:HANFORD
Mailing Address - State:CA
Mailing Address - Zip Code:93230-8569
Mailing Address - Country:US
Mailing Address - Phone:315-591-7791
Mailing Address - Fax:
Practice Address - Street 1:331 N 11TH AVE BLDG SUITE
Practice Address - Street 2:
Practice Address - City:HANFORD
Practice Address - State:CA
Practice Address - Zip Code:93230-4511
Practice Address - Country:US
Practice Address - Phone:559-582-1027
Practice Address - Fax:559-582-8105
Is Sole Proprietor?:No
Enumeration Date:2022-10-27
Last Update Date:2023-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA2926112251N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251N0400XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistNeurology