Provider Demographics
NPI:1568020394
Name:JAMES, SARA WILLINE (COTA/L)
Entity Type:Individual
Prefix:
First Name:SARA
Middle Name:WILLINE
Last Name:JAMES
Suffix:
Gender:F
Credentials:COTA/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:120 E LAFAYETTE ST
Mailing Address - Street 2:
Mailing Address - City:ANDOVER
Mailing Address - State:KS
Mailing Address - Zip Code:67002-9333
Mailing Address - Country:US
Mailing Address - Phone:316-882-3719
Mailing Address - Fax:
Practice Address - Street 1:601 N ROSE HILL RD
Practice Address - Street 2:
Practice Address - City:ROSE HILL
Practice Address - State:KS
Practice Address - Zip Code:67133-9336
Practice Address - Country:US
Practice Address - Phone:316-882-3719
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-06-05
Last Update Date:2019-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS18-01164208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation