Provider Demographics
NPI:1558716217
Name:THOMAS, SARA ANN (DPT)
Entity Type:Individual
Prefix:DR
First Name:SARA
Middle Name:ANN
Last Name:THOMAS
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 1:6000 S BUCKHORN AVE
Mailing Address - Street 2:UNIT 103
Mailing Address - City:CUDAHY
Mailing Address - State:WI
Mailing Address - Zip Code:53110-3056
Mailing Address - Country:US
Mailing Address - Phone:608-412-2843
Mailing Address - Fax:
Practice Address - Street 1:6000 S BUCKHORN AVE
Practice Address - Street 2:UNIT 103
Practice Address - City:CUDAHY
Practice Address - State:WI
Practice Address - Zip Code:53110-3058
Practice Address - Country:US
Practice Address - Phone:608-412-2843
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-05-02
Last Update Date:2016-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI13129-24225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist