Provider Demographics
NPI:1558435669
Name:ELDRED, SARAH KNOWLAND (DPT)
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:KNOWLAND
Last Name:ELDRED
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 167
Mailing Address - Street 2:
Mailing Address - City:EAST DENNIS
Mailing Address - State:MA
Mailing Address - Zip Code:02641-0167
Mailing Address - Country:US
Mailing Address - Phone:508-221-3885
Mailing Address - Fax:
Practice Address - Street 1:157 ROUTE 137
Practice Address - Street 2:
Practice Address - City:EAST HARWICH
Practice Address - State:MA
Practice Address - Zip Code:02645-1320
Practice Address - Country:US
Practice Address - Phone:508-432-5760
Practice Address - Fax:508-432-5829
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA16798225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist