Provider Demographics
NPI:1558944405
Name:MILLER, SARAH VIRGINIA (ATC, LAT)
Entity Type:Individual
Prefix:MRS
First Name:SARAH
Middle Name:VIRGINIA
Last Name:MILLER
Suffix:
Gender:F
Credentials:ATC, LAT
Other - Prefix:MISS
Other - First Name:SARAH
Other - Middle Name:VIRGINIA
Other - Last Name:LA SHIER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:ATC, LAT
Mailing Address - Street 1:1 HAWTHORNE CT
Mailing Address - Street 2:
Mailing Address - City:STAFFORD
Mailing Address - State:VA
Mailing Address - Zip Code:22554-7850
Mailing Address - Country:US
Mailing Address - Phone:540-809-1121
Mailing Address - Fax:
Practice Address - Street 1:2135 MOUNTAIN VIEW RD
Practice Address - Street 2:
Practice Address - City:STAFFORD
Practice Address - State:VA
Practice Address - Zip Code:22556-6411
Practice Address - Country:US
Practice Address - Phone:540-658-6840
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-04-29
Last Update Date:2021-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA01260023872255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer