Provider Demographics
NPI:1558031237
Name:KIYANI, SARA CHRISTINE (PT, DPT)
Entity Type:Individual
Prefix:
First Name:SARA
Middle Name:CHRISTINE
Last Name:KIYANI
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2601 NOBLEWOOD CIR APT 1512
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27604-1860
Mailing Address - Country:US
Mailing Address - Phone:678-761-1183
Mailing Address - Fax:
Practice Address - Street 1:110 COMPETITION CENTER DR
Practice Address - Street 2:
Practice Address - City:MORRISVILLE
Practice Address - State:NC
Practice Address - Zip Code:27560-9032
Practice Address - Country:US
Practice Address - Phone:919-781-4060
Practice Address - Fax:919-781-5246
Is Sole Proprietor?:Yes
Enumeration Date:2021-09-15
Last Update Date:2023-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAPT015603225100000X
NCP20761225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist